24-Hour HEMII-pH Monitoring

24-hour HEMII-pH monitoring measures reflux in the esophagus (“food pipe”) and whether it reaches the lower throat. It detects both acid and non-acid reflux, helping your doctor evaluate symptoms that may be related to laryngopharyngeal reflux (LPR).

Your doctor may recommend this test for persistent cough, hoarseness, frequent throat clearing, or a sensation of a lump in the throat. Reflux reaching the throat can occur even without heartburn.

Standard 24-hour pH monitoring measures acid exposure in the esophagus. HEMII-pH monitoring also detects non-acid reflux and measures whether reflux reaches the lower throat. Your doctor will recommend the appropriate test based on your symptoms.

A thin, flexible catheter (tube) is gently passed through your nose into your esophagus, with sensors positioned to detect reflux in the esophagus and lower throat. Numbing medication may be used to reduce discomfort during placement. Sedation is not required.

The catheter is secured to your cheek and connected to a small portable recorder. It remains in place for approximately 24 hours while you return home and go about most of your usual activities. You will record your meals, periods of lying down, and symptoms so your doctor can compare them with the recorded reflux episodes.

Your doctor will give you specific instructions about eating, drinking, and medications before the test. Depending on the purpose of testing, you may be asked to continue or temporarily stop acid-reducing medications. Do not stop any medications unless instructed by your doctor.

You may notice the catheter when swallowing or experience mild irritation in your nose or throat. You can generally eat, drink, speak, and sleep with it in place.

Unless instructed otherwise, follow your usual eating and daily routines. Our team will explain how to use the recorder and any restrictions on bathing or physical activity.

You will return the following day to have the catheter removed and return the recorder and your symptom diary. Removal is quick and does not require sedation.

Your doctor will review the results to assess the frequency and type of reflux, whether it reaches your throat, and whether reflux episodes are associated with your symptoms. The findings will help your doctor determine the next steps in your care.

24-hour HEMII-pH monitoring is generally safe. Temporary nose or throat discomfort, gagging during placement, and minor nosebleeds may occur. Serious complications, such as injury to the esophagus, are very rare.