The oesophagus is the muscular tube which allows food to pass down from your mouth into your stomach. When the stomach contents wash back up from your stomach into your oesophagus, this is called reflux. If the stomach contents are acidic, this is acid reflux. A small amount of reflux is normal but too much acid reflux typically causes heartburn and regurgitation (sometimes described as indigestion). Reflux can also cause less typical symptoms such as difficulty swallowing, chest pain, belching, hoarseness, a sore throat and a cough. The tests allow us to determine how your oesophagus moves and to measure reflux. This may help to determine the cause of your symptoms.
Manometry (pressure measurement) is used to find out if there is a problem with how your oesophagus works. It involves putting a thin plastic tube via your nose, down your oesophagus, into your stomach. In this way we can investigate how the oesophagus moves (oesophageal motility).
Reflux is measured with a thin tube which measures acid (pH) and impedance. This allows us to measure acid, air (belching) and fluid which comes up into your oesophagus. It can also help to find out how closely this reflux matches your symptoms.
These tests are used to determine whether you have excessive reflux, as your doctor suspects that this may be the cause of your symptoms. A firm diagnosis may help your doctor to treat you and hopefully reduce your symptoms.
Although having a tube inserted into your nose may feel uncomfortable and strange, there are no risks or adverse effects from the procedure. This means that there may be some discomfort, but the procedure cannot cause you any harm. We will discuss this with you in detail before starting your tests.
These tests form one part of the jigsaw of information, which your doctor requires in order to treat you. If you do not wish to undertake these tests for any reason, we will simply let your doctor know so that he or she can consider other options.
pH recording can also be undertaken using a wireless capsule (Bravo® pH recording) which measures reflux for 96 hours and avoids a catheter in the nose. Although there is less discomfort in the nose and throat, the capsule needs to be implanted during an endoscopy procedure and occasionally causes some chest discomfort. This test needs to be specifically requested by your doctor as it is only done in special circumstances.
These tests are outpatient procedures which do not require any sedation and you will not need to be accompanied to the hospital.
You must not have anything to eat or drink (except for water) for four hours before your appointment.
You should continue to take all of your medication as you would normally.
We will explain the test to you fully when you come to the department, and you will have the chance to ask any questions that you might have. Please do not hesitate to ask questions or voice any worries. If you decide to go ahead with the test, you are confirming that you agree to have the test and understand what it involves. This is known as verbal consent.
You will be asked to sit comfortably on the side of the couch with your chin tilted down. A thin tube (manometry catheter) will be passed through your nose, into your oesophagus, and down to your stomach. As the tube goes down it may cause your eyes to water, and you may retch but the procedure is not painful and once the tube is in place you will feel better. Your breathing will not be affected.
You will then be asked to swallow some salty water, and then some rice, so that the movement of your oesophagus can be recorded with both liquids and solids. Normally, this takes no more than 10-15 minutes. The tube is then removed quickly and easily. We may need to keep the tube in for longer in order to record your usual symptoms.
Next, a much thinner tube, which records reflux (pH and impedance catheter) is passed into your oesophagus in the same way as before. Once in place this is taped securely to your nose, side of your cheek and neck and remains in place for 24 hours. The majority of people have no problem tolerating this. We will teach you how to safely remove the tube yourself, so that it can be removed straight away, if needed.
The end of the tube is then attached to a small recording box worn on a shoulder strap or on your belt. Whilst the tube is in place your nose may run a little and you may experience a little discomfort in your throat and nose. Do not worry, this is normal, and will go away as soon as the tube is removed.
As we need to record what is happening over a 24-hour period, you will leave the hospital with the catheter remaining in your nose. During the study, you can go about your day without any changes to your normal activity: you should eat, drink, move about and sleep as usual. You can wash as normal as long as the recording box does not get wet.
The tube will be clearly visible, taped to your face, and so you may wish to make changes to your day because of your appearance (for example if you work with lots of people) but this is entirely your decision and no changes to your normal day are necessary for the test.
It is important that the tube stays in position throughout the study. It is very unlikely to come out by accident or when you are asleep, but you should take care that it is not pulled out by mistake (for example by children). The tube will remain in place for approximately 24 hours and will be removed quickly and easily the next day when you return to the department.
You will not be sedated and therefore you will be able to travel home and continue with your normal activities immediately after the test. This page gives you all the relevant contact details should you have any problems.
The results of the tests will be put into a report which will be reviewed by the Unit Consultant and then sent to your referring doctor. A copy will also be saved onto the hospital system and sent to your GP. When you return to see your doctor (for example at the outpatient clinic at UCH, at another hospital, or your GP surgery) the test results and any appropriate treatment will be discussed with you.
Although this is a specialist test, it is a well-recognised procedure which has been undertaken for many years and information is readily available when you search online.
Note: UCLH cannot accept responsibility for information provided by other organisations.
Alternatively, please ask you hospital doctor or GP, or contact the GI Physiology Unit, if you require further information.
This page tells you about oesophageal manometry and reflux recording but if you have read the page and have any queries please contact the GI Physiology Unit.
Address: GI Physiology Unit University College Hospital, Lower Ground Floor, EGA Wing 235 Euston Road, London, WC1E 6DB
Telephone: 020 3447 9130 (Monday to Friday 09:00 to 17:00)
Switchboard: 020 3456 7890 / 08451 555 000
Email: UCLH.
The GI Physiology Unit is on the lower ground floor of the EGA wing.
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Page last updated: 10 September 2025
Review due: 01 September 2027