Download You have been scheduled for an Upper Endoscopy

SHANDS
Endoscopy
Esophageal 24Hr
Impedance pH Study
Patient Name:
Med. Rec.#
PROCEDURE DATE:
ARRIVAL TIME:
LOCATION:
□Shands Endoscopy Center
2001 SW 13th Street
Gainesville, FL 32608
□
Shands at UF
1515 SW Archer Road
Gainesville, FL 32610
_ ___
An Esophageal Impedance pH test measures acid and non-acid reflux in your lower esophagus
using a small thin catheter placed nasally into your stomach .
.
THE DAY OF YOUR PROCEDURE:
1. Bring with you:
a. Picture ID with full name and insurance cards
b. Written List of Current Medications
2. Wear loose, comfortable clothing. (a button down shirt or blouse is best for ease of changing
clothes during the 24hour period)
MEDICATION INSTRUCTIONS:
1. Take your heart, blood pressure, seizure and Parkinson’s medication with sip of water
2. If Diabetic: Do NOT take diabetic pills evening prior or morning of procedure. Cut insulin dose in
half the night prior to procedure and HOLD any morning insulin dose the day of procedure.
3. Study is ordered ON or OFF PPI medications as instructed by your physician. (i.e. Nexium,
Prilosec, Aciphex, Prevacid Protonix and Zegrid) Patients should check with their physician or GI
Motility Lab (352-265-8982) as to whether to be ON or OFF their PPI 5 days prior to this study.
4. Over the counter medications such as Zantac, Tums, Pepto-Bismol, Mylanta, and Maalox may be
taken up to 24 hours before the test.
PREP INSTRUCTIONS:

DO NOT EAT OR DRINK AFTER MIDNIGHT THE NIGHT BEFORE YOUR TEST.
PROCEDURE:

Your nose is numbed with Lidocaine gel. A small thin catheter is gently inserted through the
nose. Upon swallowing sips of water, the catheter is advanced into the stomach. The catheter is
then attached to a portable recorder. Over the next 24 hours, the pH (acid) levels are recorded.
The recording is then analyzed and a full report is sent back to the ordering physician.
CONTACT US:


If you need to cancel or reschedule your procedure, call 352-265-0424 immediately
If you have any questions(Regarding meds, insurance/ copay information, arrival time),
please call 352-265-8982 and press option 3
Colonoscopy instructions 2012