Esophageal Manometry

What is esophageal manometry?

Esophageal manometry is a procedure that measures the strength and function of the muscles in your esophagus (the “food pipe”) that work to push food and liquids from the mouth down to the stomach.

How is esophageal manometry performed?

Esophageal manometry takes about 45 minutes. The technician will verify that you have not eaten anything within 6 hours of the study. At the start of the test, you will be sitting upright. One nostril is anesthetized with a numbing lubricant. A thin flexible plastic tube approximately one-eighth inch in diameter is passed through the anesthetized nostril, down the back of the throat, and into the esophagus as you swallow. With further swallowing, the tube is passed down into the stomach. There may be some gagging during some of the passage, but it is easily controlled by following instructions. Occasionally, the tube is passed through the mouth and not the nose.

With the tube inside the esophagus, you will lie down on your back. After a short rest to allow the pressures to equilibrate, the test will begin. The pressures generated by the esophageal muscle will be measured when the muscle is at rest and during swallows. During the test, the technician usually asks the patient to swallow on command with some water (called a wet swallow). Multiple swallows are tested to allow measurement of the lower esophageal sphincter (the barrier to reflux), the esophagus (the swallowing tube), and the upper esophageal sphincter (in the throat). Pressure recordings are made throughout the study and the tube is then withdrawn. Patients can usually resume regular activity, eating, and medicines immediately after the test.

What are the side effects of esophageal manometry?

Although esophageal manometry may be slightly uncomfortable, the procedure is not really painful because the nostril through which the tube is inserted is anesthetized. Once the tube is in place, patients talk and breathe normally. The side effects of esophageal manometry are minor and include mild sore throat, nosebleed.

When is esophageal manometry used?

Esophageal manometry is used primarily to evaluate the cause of problems with swallowing food or liquids, such as food or liquids getting stuck in the chest after swallowing. And to evaluate patients with chest pain and heartburn that may be coming from the esophagus rather than the heart.

How is esophageal manometry used?

Esophageal manometry can diagnose several esophageal conditions that affect the muscles in the esophagus resulting in food sticking after it is swallowed. For example, achalasia is a condition in which the muscle of the lower esophageal sphincter does not relax with each swallow to allow the swallowed food into the stomach. As a result, food is trapped within the esophagus. Abnormal function of the muscle of the body of the esophagus also may result in food sticking. For instance, there may be failure to develop the wave of muscular contraction to help propel the food down the esophagus (as can occur in patients with scleroderma). The abnormal functioning of the esophageal muscle also may cause episodes of severe chest pain that can mimic heart pain (angina). Such pain may occur if the esophageal muscle goes into spasm (esophageal spasm) or contracts too strongly.

Esophageal manometry is also used to evaluate patients who might have gastroesophageal reflux disease (GERD). Manometry often can identify weakness in the lower esophageal sphincter – the muscle that prevents stomach acid and contents from refluxing back up into the esophagus.

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