How to Endure the Torture of Esophageal Testing

When something gets stuck in your throat, you’ll do everything imaginable to dislodge it. That’s why when someone intentionally threads a tube through your nose and down your esophagus, you really have to fight all of your basic instincts that want to remove it.

Scleroderma can wreak havoc on the digestive tract. To monitor the damage, doctors often ask patients to do an esophageal manometry and a 24-hour esophageal pH test. For these tests, a metal or plastic catheter is placed into the nose and then threaded down into the stomach. The patient not only is wide awake for the entire procedure, but also must assist by swallowing the catheter as the nurse nudges it down.

How do you get through a test like this?

I loathe this test more than any others. There’s no way to sugarcoat it. It is a horrible experience that takes significant inner strength to get through. Each time I have to do it, I get a little better at walking myself through the procedure. Knowing what to expect helps me mentally prepare for it.

Snorting and gargling antiseptic

If you must have one of these tests, it will start with a syringe shooting a jelly-like fluid up your nostril. At the same time, you’ll be asked to sniff as hard as you can. Do it! Get as much in there as you can.

It certainly isn’t natural to snort fluid, but you will be grateful afterward. Remember, a tube must go in there, so get it as numb as possible.

After making some awkward faces and shuttering a bit, you’ll get a tiny cup filled with the same liquid you just inhaled. This time, gargle it for 10-15 seconds. Get it as far back as you can, and let it numb your throat. Your gag reflexes will be easier to manage if you embrace this step.

The first tube goes in

The nurse will lube up the end of the probe and insert it into your nose. I have no way to prepare you for this. It is far more uncomfortable than it is painful.

Close your eyes and do something that relaxes you. I like to count. I tell myself to focus on counting slowly to 10. I find that this helps me remember that it won’t last forever.

Once it reaches the back of your throat, you’ll look down and begin to sip warm water and swallow. Take little sips. The more you swallow, the faster the tube will go down into your stomach, and that’s when you’ll get a slight break. At this point, I start counting again.

Next, you will lie on your side so that the machine can get accurate readings. This part goes rather quickly.

The next thing you know, the nurse will pull out the catheter. Remember all that disgusting jelly you swallowed? It helps to numb you so you don’t feel the catheter as much when it’s removed.

The second tube goes in

You will then have another tube inserted, but it will be skinnier than the previous one. Once it’s in place, it’s then taped to your nose, where it will remain for the next 24-48 hours.

I urge you to have someone drive you home. It’s normal to be emotional after the torture you’ve just endured. And you have a foreign object lodged in your neck!

Counting to 10 repeatedly is one of the ways columnist Lisa Weber gets through a challenging 24-hour pH test. (Photo by Lisa Weber)

It feels stuck

Have warm liquids ready to sip. The heat will help make the plastic softer and more tolerable. More importantly, do not let your body try to dislodge the tube from the back of your throat.

It will feel like it is stuck. You may even start to worry it will choke you. But choking is impossible, because the tube is down much farther than you think.

Your gag reflexes will battle to get it out. Now’s the time to be mentally strong! Fight the urge to free the tube. Calm yourself.

If it becomes too difficult to bear, remain still and breathe slowly. The feeling will pass. I like to plug my nose with tissues so that I don’t have to blow it, and I chew on a washcloth. The less you swallow, the easier it is.

When you eat, take tiny bites. Chew as much as you can before you swallow. It will feel like food got stuck, but it’s just your body reacting to the tube again. The more you try to squeeze your esophagus, the worse the feeling will get. The best advice I can offer is not to fight it. Yes, it’s torture, and it’s OK to cry. But the more you struggle against it, the tougher it will be to get through the night.

This torment will end. Set small goals, such as making it three more hours. Then set another small goal. Remember that it’s not permanent.

Once the tube comes out, you’ll feel instant relief. It’s like waking up from a nightmare knowing that tomorrow you will be brand new. You are stronger than scleroderma, and this is just one more way you get to prove it.

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Note: Scleroderma News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Scleroderma News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to scleroderma.