EGD + pH Impedance Monitoring
Download printable PDFWhat to Expect
Procedure Location
St. Vincent Hospital — Pediatric Preop, Door #1
Pediatric Preop phone: (317) 338-5851
Arrive 90 minutes before your scheduled procedure
📖 About the Procedures
Your child is scheduled for an upper endoscopy (EGD) combined with pH impedance monitoring (pH-MII).
- EGD: While your child is under anesthesia, the doctor passes a thin, flexible camera through the mouth to examine the esophagus, stomach, and first part of the small intestine. Small biopsies are usually taken. This part takes about 20 minutes.
- pH impedance probe: While your child is still under anesthesia, a thin, flexible tube is placed through the nose into the esophagus. Your child will not feel this. The tube is taped to the cheek and connected to a small recorder worn on a strap. The tube stays in place for 24 hours and records both acidic and non-acidic reflux episodes, helping the doctor understand whether reflux is related to your child's symptoms.
Plan to be at the facility for several hours on the day of the procedure, and to return the next day to have the probe removed.
⏱️ Eating & Drinking — Before the Procedure (NPO)
For your child's safety, anesthesia requires an empty stomach. Stop each food or liquid below by the time listed, counting back from your child's scheduled arrival time:
| Food or liquid | Stop before arrival |
|---|---|
| Solid foodsincludes soup | 8 hours |
| Formula or milk feedingsbottle or tube | 6 hours |
| Breast milk | 4 hours |
| Clear liquidswater, juice without pulp, clear soda, clear tea, black coffee | 3 hours |
| Thickening agents added to any liquid above | 6 hours |
⚠️ If these times are not followed exactly, the anesthesia team will cancel the procedure for your child's safety.
If you don't think your child can meet these times (for example, a feeding-tube schedule or a child who won't tolerate going without a bottle), call the office before the day of the procedure so we can plan with you.
💊 Medications to Stop Before the Procedures
For the pH impedance study to give accurate results, certain medications must be stopped ahead of time. Unless your doctor tells you otherwise:
| Medication | When to stop |
|---|---|
| Proton pump inhibitors (PPIs) omeprazole (Prilosec), esomeprazole (Nexium), lansoprazole (Prevacid), pantoprazole (Protonix), others | 7 days before |
| H2 blockers famotidine (Pepcid), others | 3 days before |
| Antacids Tums, Maalox, Mylanta | 3 days before |
| Prokinetics metoclopramide (Reglan), erythromycin (when used for motility) | 3 days before |
| Sucralfate Carafate | 3 days before |
| Iron supplements ferrous sulfate, Feosol, multivitamins with iron | 7 days before |
| GLP-1 medications such as Wegovy | 7 days before |
⚠️ Stop your child's acid blocker 7 days before this study. Stop giving the acid blocker (omeprazole/Prilosec, esomeprazole/Nexium, lansoprazole/Prevacid, and similar) 7 days before the study date. If your doctor told you to keep giving it, follow your doctor's instructions.
💊 Other medications
Continue all other daily medications as directed by your child's doctor. Most can be taken with a small sip of water on the morning of the procedure.
You can verify what medications need to be stopped at meds.giready.com.
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📅 Day Before & Day of the Procedure
- Bathing: a normal bath or shower the night before is fine.
- What to wear: comfortable clothes; no nail polish on at least one finger so the oxygen sensor can read.
- Bring: a comfort item (small toy, blanket, tablet), a change of clothes, your insurance card and photo ID, any current medication list, and a bag or small backpack to carry the recorder home.
- Who comes: a parent or legal guardian must accompany the child. Plan for one adult to stay through recovery.
- Sick day rule: if your child develops a fever, new cough, vomiting, or significant cold symptoms in the 48 hours before, call the office — anesthesia may need to be rescheduled.
🏥 After the EGD — Going Home with the Probe
- Your child will wake up in the recovery area. Some grogginess, mild sore throat, and gas/bloating are normal for several hours.
- An adult must stay with your child for 24 hours after anesthesia.
- Start with clear liquids, then advance to a regular diet as tolerated.
- No school, daycare, or sports for the rest of the procedure day.
- The doctor will discuss what was seen during the EGD before you go home. Biopsy results take about 1–2 weeks; we'll send them through the patient portal or call.
- Before you leave, the nurse will review how to use the recorder and diary and make sure the probe is secure.
🏠 During the 24-Hour Monitoring Period
The goal is to capture a normal day so the results reflect your child's real-life reflux patterns.
Eating & drinking
- Feed your child their normal diet — regular meals and snacks at their usual times.
- Avoid foods your child does not normally eat.
- No chewing gum.
Activity
- Encourage normal activity — play, school, and usual routines are fine (starting the day after the procedure).
- Avoid swimming, baths, or showers (the recorder cannot get wet). A sponge bath is okay.
- Avoid rough play or contact sports that could pull on the tube.
Sleep
- Your child should sleep in their usual position (crib, bed, etc.).
📝 Keeping the diary — this is very important
You will be given a diary sheet (or the recorder has buttons). Please record:
- Meal start and end times — every time your child eats or drinks anything other than water
- When your child lies down and gets up — naps and bedtime
- Any symptoms — press the event button on the recorder AND write down the time and symptom (for example: cough, pain, spit-up, heartburn)
Accurate diary entries help the doctor match symptoms to reflux episodes. Without them, the study is much less useful.
📍 Returning the Device — Next Day
- Return the recorder and probe the next day to the Pediatric Preop area at St. Vincent Hospital (same location as the procedure) at the time given to you by the nurse.
- A nurse will gently remove the tube — this takes only a few seconds.
- Bring the completed diary sheet with you.
- Your child can return to all normal activities immediately after the tube is removed.
⚠️ Troubleshooting During the Study
| Problem | What to do |
|---|---|
| The tube comes out | Do not try to reinsert it. Call the office. |
| Your child vomits | Note the time in the diary. If the tube comes out with vomiting, call the office. |
| Nosebleed around the tube | A small amount of blood is normal. Apply gentle pressure. If bleeding is heavy or won't stop, call the office. |
| Recorder beeps or shows an error | Check that the cable is still connected. Call the office if the problem continues. |
| Significant nasal discomfort | Saline nasal spray may help. Call the office if your child is very distressed. |
📞 When to Call the Office
Call (317) 338-9450 if your child has any of the following:
Related to the EGD
- A temperature over 101°F (38.3°C)
- More than about a tablespoon of blood, in stool or in vomit, or stool that is black
- Severe or worsening abdominal pain
- Severe or persistent sore throat, drooling, or trouble swallowing
Related to the pH impedance probe
- The tube comes out or you think it has moved
- A nosebleed that won't stop
- The recorder stops working
For difficulty breathing, chest pain, or any emergency — call 911.
📥 After the Study
- pH impedance results typically take 1–2 weeks. The doctor will review the data and contact you through the patient portal or by phone.