24 hour ph and Motility studies

ReddykilowattRN · Mar 19, 2004

Yep,

I do them about once a week for a few years now. What specifically about reading them do you want to know? We use the solid state catheters now, but until last summer we used the H2O infusion system. I'm not an expert but I can tell when a person's motility is grossly abnormal. Doesn't it bother you when the LES is so loose that it is hard to locate the the tightest spot? Sometimes I have to go back and examine the graphs afterwards and have them swallow Q 1/2 centimeter throughout it. (That takes a lot of time)

ReddykilowattRN · Mar 19, 2004

Yep,

I do them about once a week for a few years now. What specifically about reading them do you want to know? We use the solid state catheters now, but until last summer we used the H2O infusion system. I'm not an expert but I can tell when a person's motility is grossly abnormal. Doesn't it bother you when the LES is so loose that it is hard to locate the the tightest spot? Sometimes I have to go back and examine the graphs afterwards and have them swallow Q 1/2 centimeter throughout it. (That takes a lot of time)

Chuckie · Mar 25, 2004

I had a crash course on Manometries and ph's last year. After seeing two and doing one with a preceptor that quit shortly after I learned I have been on my own. I have lots of ongoing questions. What is the average length of the UES? Have you ever gotten a Demeester score of over 200 when you are sure the placement is correct? I have a difficult time with Achelasia patients. Very hard to determine when I pull into the Esophagus.

ReddykilowattRN · Mar 25, 2004

I don't know the average length of the UES. Our Gastroenterologist just reads whether it is functional or not. If he sees 2 peaks in a row on 2 consecutive 5 centimeter tracings simultaneously, (after 2 swallows) then he says it's okay. Sometimes, the only way to tell you went through a nonfunctional LES is to look for the pressure inversion point. If I don't see an obvious pressure rise, then I have the pt take a deep breath. This narrows it down somewhat. Usually, what I see in achalasia patients is a tight LES and a nonfunctional body. There are always variations. What is really unsettling is when there is no pressure rise at all. I wonder how those patients get their food down? Gravity? Isn't it fun trying to get that floppy tube past a tight LES when you have an intolerant patient? I don't read Demeester scores. The doctor does that. It is all printed out from the computer. I don't have the time to study them, athough I do look at the pH tracings and check the time below 4.0. Sorry if I haven't been much help. Anyone else?

Chuckie · Apr 28, 2004

Manometries require 10 consecutive swallows, however if the patient coughs in the middle of the swallows I start over with the 10 swallows. Is this what is advised? When I first started doing them I was told to do 15-20 swallows then take the best 10. I can't see how this is appropriate.