Exams

pH & Impedance Monitoring

24h Monitoring

Ambulatory monitoring that records acid and non-acid reflux episodes over 24 hours, correlating symptoms with reflux events during normal daily activity.

Impedance monitoring detects reflux regardless of pH, essential in cases of reflux refractory to conventional treatment.

The exam in practice

AL-3 and AL-4 ZpH equipment for pH monitoring and impedance testing

Patient using the portable recorder during 24h monitoring

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Indications for the exam

Suspected GERD refractory to treatment

Atypical reflux symptoms (cough, hoarseness)

Pre- and post-operative anti-reflux evaluation

Suspected non-acid reflux

Correlating symptoms with reflux events

How to prepare

Download Prep Guide (PDF)

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7 days before

Gastric Protectors

Suspend PPIs (Omeprazole, Pantoprazole, Esomeprazole) only with guidance from the referring physician.

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24h before

Antacids

Suspend simple antacids (Milk of Magnesia, Gaviscon, Luftal) 24 hours before catheter placement.

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4h before

Fasting

4-hour fasting before catheter placement. After placement, eat normally.

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Clothing

Wear a front-button shirt: the portable recorder will be attached to your body throughout the 24-hour monitoring.

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Normal Routine

Keep your usual work and household routine throughout the exam.

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Exam Diary

Record symptoms, meal times and positions in the diary provided by the clinic: it’s essential for the report.

Frequently asked questions

What is pH and impedance monitoring?+

It’s a 24-hour ambulatory monitoring that records acid and non-acid reflux episodes through a thin catheter or capsule, correlating events with symptoms reported by the patient.

Is it uncomfortable to wear the device for 24 hours?+

It may cause mild throat discomfort in the first few hours, but the recorder is portable and allows you to keep your normal daily activities throughout monitoring.

Do I need to be hospitalized during the exam?+

No. The exam is fully ambulatory: the patient goes home with the portable recorder and returns to the clinic the next day to have the equipment removed.

When is this exam indicated?+

It’s indicated for reflux refractory to treatment, atypical symptoms such as chronic cough and hoarseness, and pre- and post-operative evaluation of anti-reflux surgery.