Reflux Diagnostics:
Dx-pH System
The first and only medical sensor able to monitor real-time, continuous pH in both liquid and aerosolized states, revealing reflux-related etiology of presenting symptoms (e.g. chronic cough, hoarseness, throat clearing, and globus). The sensor is unique in its ability to accurately function anywhere in the aerodigestive tract—from the esophagus to the nasopharynx—reporting precise values of both liquid and aerosol from pH 1–10.
THE DATA YOU NEED
To target reflux treatment
A simple pH test can result in the definitive diagnosis needed to develop a targeted reflux treatment plan. Oropharyngeal pH testing can be particularly useful in patients with atypical reflux symptoms (e.g. chronic cough, sinusitis, hoarseness), as well as those who are non-responsive to PPIs. The data reveals reflux patterns and severity, allowing a physician to adjust the treatment plan. If testing reveals no reflux, alternative etiologies can be explored.
Restech’s in-office reflux test can identify patients overlooked by conventional pH monitoring:
- The Dx-pH sensor records the pH of aerosolized material in the oropharynx. Other products lack the proprietary technology to measure aerosolized particulates, consequently missing critical data points and possibly resulting in false negative studies.
- The esophageal DeMeester and oropharyngeal RYAN Scores differ in their thresholds. Patients with extraesophageal symptoms can receive a negative esophageal pH study, but when tested by the Dx-pH System, the study could be positive.
- The upper airway is more sensitive to enzymes and acids produced in the stomach than the esophagus, meaning that smaller volumes can cause tissue damage and symptoms.
Oropharyngeal pH monitoring has provided my laryngology practice with a tool that strongly reinforces the presence of acid within the oropharynx in patients that I suspect have LPR and helps identify those wrongly diagnosed with LPR who likely have neurosensory or other causes of their symptoms. Objective demonstration of an acidic oropharynx helps convince and bolster the need for aggressive dietary management and change.
Craig Zalvan, MD
Very few products have shaped my practice in the past 20 years in the way Restech's Dx-pH System has. I believe I am making better treatment decisions as a result of this new, convenient technology. It is simple to use and easy for our patients. I believe we are serving them better and that is the goal of Siegel, Bosworth, and Sorensen ENT.
Pete Sorensen, MD
How It Works
- The pH probe is placed transnasally until the tip is just behind the uvula, high enough as to maintain maximum patient comfort. There is no need for anesthesia or any additional placement procedures.
- During the 24 hour study, the probe takes a pH reading every ½ second, while the patient inputs pertinent information such as symptoms, meals, and supine periods.
- Our DataView software program delivers the results in a simple, 1-page report format including a detailed graph, various statistics, and a proprietary RYAN Score.
- The procedure is billed under CPT 91034 and is covered by virtually all insurers.
Optimizing Reflux Therapy
A simple test provides objective data on a patient’s reflux, allowing for an individualized treatment plan consisting of dietary changes, drug therapy, Stretta Therapy, or anti-reflux surgery. On the other hand, a negative oropharyngeal pH study guides the physician to other etiologies, rather than the continued pursuit of the acid reflux paradigm.
Patient FAQs
Why has my doctor recommended the Restech Dx-pH system?
Sometimes a chronic cough is actually a gastroenterological issue and hoarseness isn’t just due to allergies or vocal hygiene. Many symptoms are non-specific, meaning the root of the problem could be several different things. Often we reflux is suspected, physicians will recommend a 24 hour pH test to find out definitively if you have reflux, as well as gain insight into what your reflux patterns are, and how severe it is. Restech’s Dx-pH test has a unique sensor, able to recognize aerosolized as well as liquid pH.
How is the Dx-pH test performed?
On the day of the procedure a clinician inserts a small catheter (about the size of a spaghetti noodle) through the nose and into the upper airway. It is then discretely taped to the cheek and wrapped behind the ear. The insertion should be painless, with minimal irritation.
During the 24 hour test, the patient records symptoms, meals, and sleep periods with a button press on the wireless recorder.
At the end of the test, a clinician will remove the catheter and generate a report of your pH test. Your physician will then use the data to craft a targeted treatment plan.
Are there any potential complications?
Restech’s minimally invasive Dx-pH device is designed to minimize any potential complications. Upon insertion, patient’s may sneeze, experience watery eyes, or feel the probe move slightly when swallowing.
Prior to the test, your clinician may ask you about nasal polyps, bone spurs, and septum deviations, as these are contraindicated (not recommended) to ensure your comfort during the procedure.
What are the possible outcomes of the Dx-pH test?
Every pH test, like every patient, is different. There are mild, moderate, and severe patients with treatments to match. Your physician may even refer you to a specialist for treatment following the test. Alternatively, the test may be negative and your physician may need to explore other causes for your symptoms.