Using an Impedance PH Pro to Measure Reflux

This video is for parents and caregivers who are looking for more information about using an Impedance PH Pro, which measures acid and non-acid reflux in a child’s esophagus. The video is presented by Keri Dowds, BSN, RN, CGRN, a clinical nurse expert in the Suzi and Scott Lustgarten Center for GI Motility at Children’s Hospital of Philadelphia (CHOP).


Using an Impedance PH Pro to Measure Reflux

Kari Dowds, RN: Hi, my name is Kari Dowds. I'm one of the nurses in the Suzi and Scott Lustgarten Center for GI Motility at the Children's Hospital of Philadelphia. This is an information video for parents and caregivers. At the end of this video if you feel it is appropriate for your child to watch, we suggest that you sit down with your child and view it together.

Sometimes after we eat or drink, we can feel uncomfortable. Food or a liquid that should stay in our stomach comes back up, this is called reflux. An impedance pH probe measures acid and non-acid reflux in your child's esophagus or food pipe. Sensors along the probe allow us to measure reflux at the bottom of the esophagus, midway up the esophagus, and at the top of the esophagus. Your physician may have ordered an impedance pH study to see if your child's medications are working to block acid or to see if your child has acid, food, or liquid coming from the stomach, back up into the esophagus.

Prior to your appointment at the endoscopy suite, a nurse will call you to explain the impedance pH probe placement, and review your child's medical history and current medications. It is important to administer your child's reflux medications the morning of the probe placement. The nurse will also explain that your child may not eat or drink two hours prior to your appointment.

Hi Brady, how are you?

Brady: Good.

Kari Dowds, RN: Good, my name is Kari, I'm one of the nurses in the endoscopy suite. I'm here today because sometimes after you eat, you have pain in your belly? So your doctor ordered something called an impedance pH study. And this study is gonna help us find out what's going on after you eat. Just give me a few minutes as I get my stuff together.

Child Life Specialist: Remember just like we talked about. Your job's gonna be to squeeze on the stress ball and take nice big swallows while nurse Kari puts that tube in.

Kari Dowds, RN: It's a really, really thin probe. See how thin it is? It's not even as fat as spaghetti. And I'm gonna put this special jelly on the outside so that'll help the probe slide in. So we're gonna put it in your nose and it's gonna go down into your esophagus. And then once it's where we want it to be placed, we're gonna put this special tape on the side of your cheek, and that keeps the probe in place. You ready? So when I tell you to, I want you to swallow. Cause your swallowing helps the probe go down. Ready? And swallow, swallow. Great job. Alright we got it where we want it to be. Alright I'm gonna put this special tape on it.

Child Life Specialist: You can hold on to my hand if you'd like to.

Kari Dowds, RN: Alright, and then let me put my tape on. Perfect. And this will help keep it in place. Sometimes you do sneeze once it's in, but you'll get used to it, I promise.

An X-ray will be done to confirm the location of the impedance pH probe in your child's esophagus. Sometimes, we may have to adjust the placement of the probe a few centimeters after the X-ray. Once the correct placement has been confirmed, the twenty four hour study begins. The probe is connected to a recording device that will display your child's name, date, and time. You will use the time on this device when filling out your child's diary.

During the 24 hour study, you will be asked to complete a diary. The diary consists of meals, medications, and symptoms that your physician has asked you to document. We do ask for the meals that you refrain from having apple juice or orange juice because these are acidic and cause an incorrect reading. Your child may be on other medications other than GI medications that they may take, but we do not need to document them on the paper. And your physician will have designated a symptom to be monitored. These symptoms are often cough or chest pain.

At this point, you and your child will be discharged to home and return the next day to have the probe removed. Some patients, like children under three, may be admitted overnight to the hospital, till the end of the study. Your physician will decide prior to your appointment if you will be admitted or not.

Now we're gonna take it out. First thing I'm gonna do is remove the tape. Just like a band aid coming off. And you sneeze sometimes when it comes out too. I'm gonna take the tape off. And on the count of three I'm gonna pull it out. One, two, three. It's out!

Child Life Specialist: Good job!

Kari Dowds, RN: Great job!

Brady: yea!

Kari Dowds, RN: The information on the recording device will be downloaded and any information on your child's diary will be imported into the computer. Your physician will then analyze all this information and follow up with you in one to two weeks with your results.

Thank you so much for watching this video. If you have any more questions, please contact your physician. Your child's care is our top priority.


Related Centers and Programs: Suzi and Scott Lustgarten Center for GI Motility