24-hour pH impedance

This test records reflux over about a full day using a slim catheter placed through the nose into the esophagus and taped in place. Along with acid, the impedance sensors detect non-acid reflux — material that comes back up without being acidic — which a pH measurement alone would miss. The catheter connects to a small recorder you wear.

Dr. Gomez may recommend it when reflux symptoms continue despite acid-reducing medication, or when it is important to know whether cough, throat clearing, or chest discomfort line up in time with reflux events. Because it captures both acid and non-acid reflux, it can explain symptoms that acid testing alone leaves unanswered. The results shape what to treat and what to stop treating.

The catheter is placed in the office without sedation, after the nose and throat are numbed. It is about the width of a piece of spaghetti and is worn for roughly a day, so you go home with it and eat and sleep as you normally would while pressing a button to mark symptoms. Many people are aware of it in the throat at first and adjust within the first hour or so. You return the next day for removal, and the recording is reviewed with you.