Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; prolonged (greater than 1 hour, up to 24 hours)
CPT4 code
Name of the Procedure:
Esophageal Function Test
Gastroesophageal Reflux Test with Nasal Catheter Intraluminal Impedance Electrode(s) Placement, Recording, Analysis, and Interpretation; Prolonged (Greater Than 1 Hour, Up to 24 Hours)
Summary
This procedure tests how well the esophagus works and identifies acid reflux by placing a specialized catheter through the nose into the esophagus. The catheter stays in place for a period ranging from over an hour to up to 24 hours to collect data on esophageal function and acid exposure.
Purpose
To diagnose issues related to esophageal motility disorders and gastroesophageal reflux disease (GERD). It helps measure the movement and pressure of the esophagus, and detects the presence of acid reflux, thereby guiding appropriate treatment.
Indications
- Persistent heartburn
- Difficulty swallowing
- Chest pain not related to heart issues
- Regurgitation of food or sour liquid
- Diagnosed GERD not responding to treatment
- Suspected non-acidic reflux
Preparation
- Fasting for 6 hours before the procedure.
- Temporarily stopping certain medications, including acid suppressants, as directed by your healthcare provider.
- Undergoing preliminary assessments like an esophagram or upper endoscopy if required.
Procedure Description
- A thin, flexible catheter with impedance electrodes and a pH sensor is gently inserted through the nose into the esophagus.
- The catheter is secured in place with tape.
- The patient is sent home with the catheter in place and asked to continue normal daily activities while avoiding certain activities like eating and drinking excessively.
- After a set recording period (up to 24 hours), the catheter is removed.
- The collected data is analyzed and interpreted by a specialist.
Duration
The procedure involves an initial setup that takes about 30-45 minutes, followed by a monitoring period from over 1 hour up to 24 hours.
Setting
The initial placement is usually done in a hospital or outpatient clinic, with the monitoring period occurring at home.
Personnel
- Gastroenterologist
- Nurse or medical technician for catheter placement
- Data analysis performed by a specialist
Risks and Complications
- Mild discomfort during catheter placement
- Nosebleeds
- Sore throat
- Gagging or coughing
- Rare risk of infection or damage to the nasal passage or esophagus
Benefits
- Accurate assessment of esophageal motility and reflux.
- Helps diagnose the cause of symptoms, guiding effective treatment.
- Information gained can help avoid unnecessary surgery.
Recovery
- Immediate return to normal activities after catheter removal.
- Any soreness or discomfort should resolve quickly.
- Follow-up appointment for discussing test results.
Alternatives
- 24-Hour pH Monitoring: Monitors acid reflux without impedance measures.
- Pros: Simple, shorter placement time.
- Cons: Less information about non-acid reflux.
- Esophageal Manometry: Measures muscle contractions in the esophagus but doesn’t measure reflux.
- Pros: Provides detailed motility data.
- Cons: No reflux information.
Patient Experience
- Initial discomfort due to catheter insertion through the nose.
- Feeling of something being stuck in the throat.
- Most patients adapt quickly and can go about daily routines.
- Light sedation may be used during placement; resulting in minimal pain during the procedure.
- Pain management typically unnecessary, but over-the-counter pain relief may be used if required.