So DS [who is doing VERY well and hit 20lbs last week!] had surgery a little over a year ago. One of the tests they did leading up to that was a pH probe test. His 'score' was a 21 and anything over 15 was considered GERD iirc.

Is there anyone who can help me interpret that? I can't remember what [if anything] my doc said about what the 'highest possible score' on it was etc. and Googling isn't helping. Either I'm not finding the right search combination or something because all I'm getting is instructions for before the test.

Anyone?

Thanks .
Carol

A pH test measures how acid or basic a substance is. Normally the lower the number the more acidic and the higher the number the more basic with 7 (on the pH scales I remember using) being neutral.

In terms of this test they've reversed the values to indicate that the higher the number, the more acidic. Since the acid in the stomach is highly acidic the 'score' of 21 according to this scale probably indicates that the acidity levels in the body are very high if we assume that 15 is considered neutral.

I'm not a doctor so I'm not sure that I am correct, but I am using stuff I know from having done chemistry. So I hope this helps if only a little.

That makes sense, though I think it would still be 7 would still be neutral with 15 being bad enough to qualify as GERD rather than just annoying or whatever.

And it would make sense that they would switch it since they're not generally going to be measuring basic in that kind of test and if they hadn't he'd be a -7 instead of a 21.

So there might not be a 'highest' score per se, just that anything over 15 would be bad and 21 would be pretty bad - 2xs? [3xs?] as acidic as neutral [is that even right? I know what I mean .]

Thanks .

Anyone else?
Carol

This is probably useless for your purposes, but I know from my dad that a pH score below 4 is particularly damaging for GERD patients when measuring acid in the esophagus. But your score could easily be scaled specifically for the probe test, or they could have different numbers for things in pediatric gastroenterology? Shame it's not you; I could have brought a lot more to the table.

Glad to hear he's doing well!
JD

Hi, Carol!

I looked at my normal lab values chart that I have for rounds, and either the doc's using some random scale or those are values from a different test . . . ? Plus, there is no value above a 14 on the pH scale, as 14 is the value for a solution of only strong base with absolutely no acid, so a value of 21 is impossible (unless he multiplied the pH by 10 to give you a whole number instead of a decimal, which is possible). That being said, he might have been measuring the volume of acid in the stomach, which may be a more likely scenario with the numbers you gave. The pH probe should have measured from a 3 to a 6, normally.

I wish I could tell you more, but I'm still a baby in the medical field.

Well, I'm not sure about this either, but as Med Student in her last year, I'd say that they're not talking about the pH scale itself.

I'd guess that the 21 is a count. You measure how often there is acid reflux into the esophagus. It's normal for everyone to have a bit of reflux, but that shouldn't be too often, because the esophagus needs a bit time in order to neutralize the acid.

I'm going to look this up for you.

It might also be a score. The German papers concerning GERD name a few different items, like duration of reflux, percentage of time in which the pH was lower than four, and circumstances in which the reflux happens (patient is standing, lying, etc.)

In Germany there doesn't seem to be something like a score for GERD, but maybe the US physicians use one.

Pretty much what Bakasi said. When they do pH or motility probes, they measure the number of times/hour that acidic material is detected refluxing up into the esophagus.
The issue with GERD isn't really how acidic the material (stomach acid is always going to be acidic), the issue is how often the lower esophageal sphincter loses its tone and allows the acidic contents to move back up into the esophagus.
Surgical procedures can change the actual inlet to the stomach - Nissens, Thals, etc. Medications for reflux make the material less acidic, but have much less effect on how often the material makes it back in to the esophagus.

DS had a Nissen? Is that right? Glad he's doing better!
Jill

Glad to hear about your DS, Carol. Those little ones are so helpless and they tear your heart out even when everything is going well for them. Just remember, after he gets older he won't want to hear about what you went through for him when he was so little, especially when you tell his girlfriends about it all.

Hehe.

We're just glad that his scars won't ruin his swimsuit modeling career .

Thanks guys. I'm guessing then that the 21 is an average per hour or how many times over a certain ph balance or something. I was curious as to what the top score possible was and I couldn't find the info anywhere...

Carol