Here are some general preparation instructions for the most common testing for acid reflux and GERD. Keep in mind that Digestive Health Center testing locations might use slightly different instructions. We have included these instructions for education purposes.
Please refer to the instructions of each testing site for official use.
Upper Endoscopy (EGD)
- Do not have any solid food or dairy products after midnight the day before. You may have clear liquids until four hours prior to your procedure. Examples of clear liquids: water, smart water, sport or power drinks with electrolytes, clear soup broth, clear fruit juice (no red), coffee/tea (no red), sodas, plain Jell-O (no fruits or toppings), popsicles or Italian ice (no red and no milk).
- You should take your medications, including heart, blood pressure, thyroid and seizure medications as directed until four hours before the procedure with a small sip of water
- If you have asthma, use your inhaler as directed and bring it with you
- You may brush your teeth
- Please make sure you have arranged ahead of time for a responsible adult (age 18 or over) to drive you home after the procedure.
- If you are a diabetic: To avoid low blood sugar, please do not take your oral medications for your diabetes or insulin the morning of your procedure. You can resume your diabetes medications after the procedure, once you have eaten. If you are taking insulin, please check with your prescriber as to the best way to manage your blood sugar. Please bring your insulin with you. If you are unsure about taking any medications, please call.
- If you are taking blood thinners such as Coumadin, Plavix or aspirin, they may need to be stopped prior to your procedure. Please ask your doctor. These medications are usually stopped several days before your procedure.
- Wear loose, comfortable clothing such as a sweat suit. No jeans or metal – including zippers and bra hooks (sports bras only). Leave jewelry at home including belly rings & tongue piercings.
- If you are a smoker, do not smoke at least six hours before the procedure.
- You will receive sedation for the procedure, so do not drink alcohol, drive or make important decisions for the 24 hours following your procedure.
Manometry
- If your test is scheduled before noon, do not have anything by mouth after midnight the day before. If you are scheduled for after noon, you may have a light breakfast until 8 am (examples: yogurt, oatmeal, eggs, or toast with tea, coffee or juice).
- Wear comfortable clothing, preferably with a button-down or zipper front.
- Be prepared to provide a full medical history:
- History of your symptoms such as reflux, regurgitation, burning, nausea, chest pain, and any symptoms you feel are bothersome
- List of medications taken for all medical conditions, heartburn, and over the counter (OTC) meds
- Nasal abnormalities or nasal surgery
- Allergy history, especially local anesthetics like xylocaine, lidocaine, or any other medications doctor may have told you to avoid
This test should take about 20 minutes. You can resume a regular diet upon leaving.
pH monitoring
There are two versions of this test: Bravo pH monitoring and 24-hour pH-impedance testing.
Specific instructions are not the same. But usually, unless otherwise specified, you will have to stop all GERD medications seven days before your procedure. You should avoid taking GERD medications for the duration of the test.
Not stopping these medications will alter the results of the test. It is important to ask your ordering doctor for specific instructions.
Common GERD medications include:
- Nexium (Esomperazole)
- Dexliant (Dexlansoprazole)
- Aciphex (Rabeprazole)
- Prilosec (Omerazole)
- Prontonix (Pantoprazole)
- Zegerid (Omeprazole/Sodium Bicarbonate)
- Carafate (Sucrafate)
- Pepcid (Famotidine)
- agament (Cimetidine)
- Axid (Nazatidine)
Non-GERD medications for other medical problems (example: diabetes, high blood pressure) should not be interrupted.
Bravo pH monitoring
This test is done during an upper Endoscopy (EGD). Please refer to the “Preparing for Upper Endoscopy (EGD)” section for instructions.
- Once the capsule is placed, the monitor must stay within 3 feet of you during the duration of the test to pick up the capsule’s signal. It will beep to let you know if it is too far away. To stop the beeping, simply place the monitor close to your chest and it will pick up the signal again.
- You may shower, do not bring the monitor into the shower. It is best to cover the monitor with a plastic bag. You will be instructed on how to use the monitor and when to bring the monitor back at the time of discharge.
- The small capsule will detach from you esophagus within 7 to 10 days. It will pass through the digestive tract and is eliminated from the body.
24-hour pH-impedance testing
If a manometry was also ordered, the 24-hour pH-impedance testing test can usually be done the same day immediately following the manometry.
- If your test is scheduled before noon, do not have anything by mouth after midnight the day before. If you are scheduled for after noon, you may have a light breakfast until 8 am (examples: yogurt, oatmeal, eggs, or toast with tea, coffee or juice).
- Wear comfortable clothing, preferably with a button-down or zipper front.
- After the test, a small catheter will be taped to your cheek and neck. Do not disconnect the monitor from the catheter until the test is completed. Do not shower or bathe during the test.
- The catheter may tug at your throat during eating and swallowing. This is normal.
- The day of your testing, you will receive instructions to self-remove the catheter, or you may return and have it removed.
Upper GI/ Barium Swallow
- Do not eat or drink anything six hours before the test.
- You will be asked to drink barium liquid preparation. A chalky drink with consistency. The barium will be seen on fluoroscopy (X-ray).
- The procedure may take about 30 minutes.
Gastric-Emptying Study
- Do not eat or drink anything four hours before the test.
- Do not take any pain medication four hours before the test.
- The test may take up to four hours to complete.