Effect of ambulatory 24-hour esophageal pH monitoring on reflux-provoking activities

Ambulatory 24-hr esophageal pH monitoring is considered the gold standard f or diagnosing gastroesophageal reflux disease (GERD). The current approach is to encourage patients to pursue their everyday activity in order to obta in near-physiological recordings. However, the effect of the test itself on reflux-provoking activities has never been evaluated. Thus, the aim of our study was to assess daily food consumption, habits, symptoms, sleep, and p erceived experience of patients undergoing pH testing as compared to an off test (normal) day. Patients reported type and time spent in each activity pursued, food ingested and length of each meal, habits, frequency and sever ity of GERD and other related symptoms, sleep disturbances, side effects, a nd overall perceived experience during pH testing and four weeks later, dur ing a normal day. Fifty-four patients enrolled. pH testing significantly re duced time spent being active, number of meals and cups of coffee consumed, and frequency of GERD symptoms. Almost half of the patients reported havin g dysphagia during the test. Most patients experienced side effects and sta ted that the test bothered them most of the time. In conclusion, pH testing has a significant effect on decreasing reflux-provoking activities-patient s tend to assume a more sedentary lifestyle. This may influence the reliabi lity of the test as a physiologic measure of acid reflux.