Audit of 24‐hour pH monitoring in a large teaching hospital – are current guidelines being followed?

Twenty‐four hour pH monitoring is an expensive, time‐consuming and uncomfortable investigation only necessary in a small proportion of patients with gastro‐oesophageal reflux disease. Guidelines have been published by the British Society of Gastroenterology, in order to clarify those patients likely to benefit. Aims to assess whether these guidelines are being followed in a large teaching hospital. A random selection of the notes of all patients referred for 24‐hour pH monitoring at the Queens Medical Centre were assessed for the appropriateness of referral. A total of 114 patients were referred for pH monitoring, and the notes of 77 of them reviewed. This audit shows that in the majority of cases guidelines are being followed. Referrals from non‐gastrointestinal specialties accounted for 50 per cent of cases where they were not. In addition, 40 per cent of all referrals from non‐gastrointestinal specialties failed to follow guidelines, suggesting that this group is either educated further as to their contents, or that all patients referred for 24‐hour pH monitoring see a medical or surgical gastroenterologist prior to the investigation.