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Question about esophageal pH (Bravo pH study being done now)
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Question about esophageal pH (Bravo pH study being done now)

(I asked this in the Gastroenterology forum, but upon reflection thought it to be just as fitting if not moreso here.)

I'm currently undergoing the Bravo pH 48-hour esophageal acid exposure test. For the test, I've decided to revert to "bad" eating habits, to put myself under enough stress to show anything there might be to show.

I'm wondering, how normal is it for esophageal pH to drop below 4.0. (What's a normal level of acid exposure?) I'm not trying to manipulate the tests results, I'd just like to understand what I'm seeing, if it's even worth understanding.

The monitoring device I have on me now is quite interesting in that it not only displays the time, but also displays a pH reading. I've noticed that the pH on this thing has gone from ~8.0 to as low as 1.8 (may have gone lower, but I hadn't noticed). Most of the time (easily 90%+) it goes between 4.0 and 7.8, with the lion's share of that being in the upper ranges, though one time, right after implantation, I had a cup of cold water and the pH dropped to 2.8 for a few seconds. (Dirty water?) And last night I had an incident in which the pH reading bottomed out at ~1.8, and spent no more than a few minutes under 4.0. (Had eaten pizza a few hours before, and was now sitting in a slouching posture.) I presume that means acid exposure, but is that brief a level of acid exposure "normal"?

One thing's for sure, if the readings in this thing are what I think they are, then my symptoms are almost entirely NOT caused by prolonged acid exposure, at least not that the monitor's picking up. After some pizza yesterday I've felt as if my throat was burning. (The main reason I all but gave pizza up to begin with.) The burning feeling continues to this morning; I wish I could chew some frigg'n gum!

**Edit: 1.5h after eating breakfast pH has consistently hovered between 3.1 and 5.8. Most of the time it's been above 4.0, but there have been stretches where it hung out around 3.8. 5.5 as of this writing.**

Thanks in advance.
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620923_tn?1405964489
Hi, I find this very interesting and hope u learn enuff to explain this to all of us!!! : )


"selma"
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Avatar_m_tn
Alright, well no answers received, but a lot of digging answered some of my questions.

The normal esophageal pH is between 7 and 4 (or 5, depending on who you ask). If the pH stays in one range for a long time (say between 4.5 and 6.1) then that seems to indicate normal esophageal function. If there's a sudden drop (from 7 to 5.3) that indicates possible reflux (might be acid, might be regurgitation).

Sometimes the pH will drop below 4. This is definitely acid reflux, though I don't know how much is considered "normal". I presume my dips into the 2.x and 1.x territory weren't. Sometimes the pH will go above 7 (mine went to 8.6 at one point, and spent more time than I'm comfortable with at 8.1), which isn't conclusive to anything, but might indicate the presence of bile reflux. There's no real way to tell with this kind of test, however, as the stomach seems to have some alkaline periods. It may also be an indication of regurgitating acidic foods. Again, I don't know how much is considered "normal".

(Come to think of it, I should have tested Apple Cider Vinegar to see if I spotted any sort of pattern with it, whether it really does turn alkaline once in the stomach or not.)

My pH (from the readings I saw) ranged from 1.9 to 8.6, with the vast majority of the time being between 4.2 and 7.5, depending on what I'd eaten or drank recently. Breads/cereals seemed to make me very acidy and most likely to reflux, usually an hour after ingestion. Juices tended to make things acidy almost immediately, first from drinking the juice (which apparently has a pH of about 5.2) then from digestion (which would drop the pH to just above 4). Salads seemed to make things very alkaline (the pH stayed between 6 and 8 after salads), and the Teeccinno coffee substitute I drink made things VERY alkaline (this + salad = pH > 8.0). The last two foods were by far the most comfortable.

Symptoms were not necessarily (although mostly) associated with lowered pH. I suppose this part, however, is very personal, and correlation doesn't necessarily indicate causation.

I'll be getting my results about a week after the return of the monitoring device, although I expect that I'll be getting my gallbladder removed before then. (Attacks are increasing in severity and becoming more and more common. I've held on to this thing as long as I could, but now even water's stating to give me issues. Sadly, a GB attack which lasted almost 10 hours ruined a whole day of the testing. Luckily it was a 48-hour test. As someone with GERD, I would find it extremely valuable to have a monitor like this available to me at all times.)
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620923_tn?1405964489
Wow....u learned alot from this.....may I ask how was this adfixed to u...and was it uncomfortable?

I have had water be an isues for me also...it was yrs ago, but I do remember how baly I felt and I lost quite a bit of weight.

I am sorry to hear ur attackes are more frequent.....I know how terribily painful and how awful it can make u feel.

Please keep me posted when u get ur results

"selma"
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Avatar_f_tn
New here..just had the bravo also..was told to still take my 2 prevacid a day...did not understand any of it..I have battled acid reflux for 2 yrs now. I am now finding out for the second time that I have a bacterial infection in my stomach.(had first about 9 months ago) was on the prepack for 2 wks for that..now my chest hurt REALLY bad..called dr today...talked to the one on call...told me with the chest pain that I should monitor temp.could have a tear in my esophagus. I am so sick of this..cant eat anything..just read a something about Celiac disease...I have so many of the symptoms. I have also had IBS since my late 20s..Just so sick of this...wanted to talk to someone that knew what I am talking about.
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Avatar_m_tn
Basically, yes, it was an uncomfortable procedure. Luckily, it was also short, only taking about a minute. Some people complain about feeling like they have a pill stuck. I didn't feel a thing after it was initially implanted.

I don't need to wait for the report to know one thing: I definitely have some kind of reflux. I should get the results in about a week, though. I'll update then.

@Tootsie59
Post that as a separate question and either I or someone else will address it.
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Avatar_f_tn
never mind..just wanted to talk to someone that knew what I was talking about..sorry I made a boo boo....sorry  I bothered you.
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Avatar_m_tn
No bother. Don't mind chatting about whateter's the matter. Based on what you wrote, it seems the topic very much deserves its own thread, and hiding it down here, under a headline that has little to do with what you write, doesn't do it or you justice.  Also, coming up with it in the middle of a thread may be distracting to anyone who comes here (via search engine or otherwise) for the thread's topic. (The term is "threadjacking".) If you start a new thread with that very text you put up there it allows more people to come into the conversation, because it makes it far easier to find and to keep on topic. Again, really, it's to your advantage. Hope to hear from you later.
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Avatar_f_tn
I just had the bravo procedure done and I am experiencing sever chest pain, especially while swallowing food or liquids. They gave me pain killers but they don't work. Is this normal and should I be concerned?
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Avatar_n_tn
Just had my bravo in this morning.  I am not noticing pain with it.
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Avatar_m_tn
Just had the 48hr pH study started yesterday. Ever since waking up from the procedure my chest pains have increased a 10 fold intensity. I am in almost constant agony, especially right after swallowing food and liquid. Sometimes I get sharp shooting pain from the sight just from making the swallowing motion without eating/drinking anything. I also get terrible pain if I talk too much, breathe too deeply, yawn, etc.

Went to doctor today b/c pain was so severe and he basically just blew it off saying some people have hypersensitive nerves that over stimulate upon feeling the capsule on the wall and that it happens in a small minority of people and that the majority don't even feel anything. Am taking narcotics, muscle relaxer, with barely any relief. If I had known this was going to be so painful would never have had it done. I can't believe this is all from If it doesn't improve by next week I am going to demand they remove the capsule by endoscopy. This thing could take up to 2 weeks to dislodge on its own and I'm not living with this agonizing pain for that long.  
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329165_tn?1385201516
I only read this post today.  In my experience I would recommend someone with GERD issues to rather go for the impedance study (also 24 hour test with pipe through the nose to the tummy) as it is so much more accurate than just the PH test.  They don't do the Bravo capsule around here.

I had the 24hr PH study done end July and it came back as NORMAL and I thought they are nuts because I battle with a permanent sore and red throat for more than 10 months now and I have reflux all the time!  So I went to a Gastro-doc (the other test was done by a General Surgeon) and the the Gastro ent. discovered that I have "gastric inlet patches" at the top of my esophagus and Barrets at the lower end because of constent reflux!
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Avatar_m_tn
In hindsight, had I known I would have gotten that kind of pain from the bravo pH test, I would have opted for the 24HR tube through the nose deal.

Luckily, on day 4 the capsule must have dislodged b/c the pain got progressively better as the day went on. Now, I'm just back to my usual pre procedure chest pains/discomfort when eating, etc.

Won't get the results for 2 weeks and see where I go from here.
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Avatar_f_tn
Just had Bravo implant, I am a bit surprised as my pH level is mainly reading 1.0 -1.6, I have almost constant stomach and throat pain, I normally live on Gavison antacid tablets (have had 96 gaviscon tabs in 2 weeks) on top of my Ranitadine 300 mg a day but have been told not to have anything during the 48 hr test. Don't know how this will pan out.
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Avatar_m_tn
I also currently have bravo implant. I have the severe chest pain and had chest pain prior to the test, but it increased the pain especially with swallowing food. I questioned the Nurse who did the procedure. She said the pain is because I have a hiatal hernia. The pain was severe and scary.
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Avatar_m_tn
I just had the Bravo the study was done and am on day 5.   The pain initially was intense and has settled down but I still feel it.  I called my doctor just to ask if this is normal and he never called me back.   I'm not sure how long to wait before being a little more forceful about how I'm feeling.   A friend had mention that I should go to urgent care and get an X-ray not sure what to do.
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