Norm of Esophageal Acidity Test (Tuttle Test)
|Esophageal reflux pH||≤5.0|
Usage of Esophageal Acidity Test (Tuttle Test)
Helps diagnose gastroesophageal reflux.
Description of Esophageal Acidity Test (Tuttle Test)
A test that evaluates the integrity of the esophageal sphincter by measuring the pH of gastric and esophageal contents using a pH electrode attached to an esophageal catheter introduced through the mouth and esophagus. This test may be performed with esophageal manometry.
Professional Considerations of Esophageal Acidity Test (Tuttle Test)
Consent form IS required.
Aspiration and chemical bronchitis, vasovagal response.
Clients at high risk for poor tolerance of a vasovagal reaction (i.e., clients with known cardiac instability).
- See Client and Family Teaching.
- Verify that the client has fasted.
- Obtain a gastric catheter with a pH electrode, and 300 mL of 0.1% N hydrochloric acid (HCl).
- Establish intravenous access. Have 0.9% saline and atropine on hand for use in the event a vasovagal response occurs.
- The client should void just before the test.
- Just before beginning the procedure, take a “time out” to verify the correct client, procedure, and site.
- Place the client in a high-Fowler's position.
- Assess for vasovagal reaction, dysrhythmia, cyanosis, or coughing during the procedure.
- Introduce the catheter with a pH electrode through the mouth to the back of the throat. Instruct the client to swallow, perform the Valsalva maneuver, or lift the legs to stimulate reflux to catheter level, and then determine the pH.
- If the pH is normal, pass the catheter into the stomach, instill 300 mL of 0.1% N HCl over 3 minutes, and repeat step 2.
- Assess vital signs every 30 minutes × 2. Extend assessments as needed if the client was treated for a vasovagal reaction during the procedure.
Client and Family Teaching
- Fast from midnight before the test and avoid smoking for 24 hours before the test.
- Do not drink alcohol for 24 hours before the test.
- The physician may want you to stop taking adrenergic blockers, antacids, anticholinergics, cimetidine, cholinergics, corticosteroids, and reserpine for 24 hours before the test. Check with your doctor before stopping any of your medicine.
- You must swallow a catheter with a small electrode attached, which will measure the amount of acid in your esophagus and stomach. After the measurements are taken, the electrode will be slowly pulled out of your stomach.
- The test takes 30 minutes or less.
- The results are immediately available.
Factors That Affect Results
- Antacids, anticholinergics, and cimetidine may decrease pH. Adrenergic blockers, cholinergics, corticosteroids, ethyl alcohol (ethanol), and reserpine may increase pH.