New Reflux Tests at Mercy Hospital Lebanon

February 18, 2014

Impedance/pH Total Reflux Monitoring

Rich, tasty foods can sometimes be synonymous with acid reflux, but what if it’s not the food you’re eating that’s giving you a painful reaction?

Robert Davis, 68, spent much of the last decade battling extreme bouts of acid reflux. “There for a while, some foods were upsetting my stomach to the point that I’d get diarrhea. I was becoming a prisoner.”

He had to cut out peppers from his diet, among other favorites, while doubling up on antacids. But Davis’ immunity grew stronger and one day, so did the pain. “It felt like a heart attack. There was so much pressure in my chest and I could hardly swallow. It was very scary.” So Davis visited his doctor at Mercy Clinic Family Medicine – Lebanon, who ordered a routine endoscopy to scope out the problem.

“We looked at his esophagus and that came back relatively normal, so we did a barium swallow x-ray, which showed abnormal spasms,” recalled Dr. Samira Hasan, who then ordered further tests using brand-new Sandhill Scientific equipment: a manometry study and pH probe. “The High Resolution Impedance Manometry probe involves swallowing two types of liquids, and follows how the muscles of your esophagus contract and how much of what you swallowed makes it all the way to your stomach.”

That was followed by a much smaller pH probe. “They put that tube down my throat for 24 hours,” recalled Davis. “It had wires attaching it to a computer I wore on my belt. It wasn’t so bad, actually, once I got home and got used to it. I forgot it was even there.” David did have to take note of naps and meals. “I’d input that data into the device, and it gave us a tremendous amount of information to help them diagnose.”

Davis turned out to have a “nutcracker esophagus,” in which spasms cause extreme pain. “Reflux wasn’t the problem at all. His esophagus was just contracting too strongly,” said Dr. Hasan. “Because his issue was muscular, I prescribed him medicine to relax that muscle.”

“My problem is now 99% resolved,” said Davis. “I have very few episodes now. It turned into a blessing of them finding everything out and getting me on the right track.”

“Anyone who has issues with swallowing can benefit from the study,” added Dr. Hasan, but she notes that Davis’ diagnosis is rare. “Most people will have issues with reflux, and there are a number of things we can do, like adjusting medications. Some people will be a candidate for an anti-reflux surgery – especially if they’re young and looking at a potential lifetime of medications or the medication is not controlling the reflux adequately.”

If patients have longstanding reflux, Dr. Hasan suggests they have it evaluated. She says there is some relationship between reflux and changes to the lining of the esophagus, which is a condition called Barrett’s esophagus. “And in some very rare circumstances, there is a link to esophageal cancer, so it’s best to talk to your doctor early.”

Dr. Hasan is among a three-surgeon team at Mercy Hospital Lebanon, located at 100 Hospital Drive. She provides general surgery expertise including advance laparoscopic surgery, colon cancer surgery and anti-reflux surgery.

To learn more about High Resolution Impedance Manometry or Impedance/pH Total Reflux Monitoring, visit