What is an esophageal manometry?
The esophagus is the muscular tube that connects the throat and the stomach. The esophagus moves the food down to the stomach with wave-like contractions initiated by swallowing. This process is known as peristalsis.
Another ring of muscles at the bottom of the esophagus (lower esophageal sphincter) opens to let the food pass into the stomach and closes to prevent it from coming back up along with stomach acid.
Esophageal manometry is a procedure performed with a thin, flexible, pressure-sensitive tube. The procedure tests the function of the esophagus and the esophageal sphincters by measuring the pressure they generate.
Why is an esophageal manometry done?
Esophageal manometry is used to determine if the esophageal muscles are functioning normally. Esophageal manometry is usually performed to find the cause of symptoms such as:
- Difficulty swallowing (dysphagia)
- Painful swallowing (odynophagia)
- Feeling of food being stuck in the throat
- Heartburn or reflux
- Non-cardiac chest pain
Esophageal manometry helps in the diagnosis of conditions such as
- Achalasia -- dysfunction of lower esophageal sphincter (LES)
- Distal esophageal spasm -- uncoordinated contractions
- Jackhammer (hypercontractile) esophagus -- extra powerful contractions
- Absent or ineffective peristalsis
- Hypotensive lower esophageal sphincter
- Systemic diseases such as scleroderma, which can paralyze the esophagus
Esophageal manometry may also be performed
How is an esophageal manometry performed?
Before the procedure the patient
- Must not eat or drink anything for 8 hours
- Must check with the doctor before taking any regular medications
- Inform the doctor if they
- The patient initially sits upright.
- The doctor applies a numbing lubricant to the nostril.
- The doctor inserts a thin pressure-sensitive tube gently through the nostril, pharynx, down the esophagus through the LES into the stomach.
- The patient must follow instructions from the doctor and swallow tiny sips of water at intervals.
- After the tube insertion the patient will lie down.
- The manometry machine will record the pressure readings from various points on the tube for the doctor to interpret.
- The doctor will slowly withdraw the tube.
- The patient will be able to leave immediately after the procedure.
- The patient can resume a regular diet after the procedure.
What are the limitations of esophageal manometry?
Esophageal manometry is a useful test but has certain limitations. Because swallowing problems and spasms do not occur all the time, there is no certainty that the problems will occur during the test, hence the results may not be conclusive for a diagnosis.
Is it painful when you have an esophageal manometry?
Esophageal manometry is generally not painful. During the insertion of the tube some may feel
What are the risks and complications of an esophageal manometry?
Esophageal manometry is generally a safe procedure and complications are rare. There are a few mild side effects such as
These side effects usually resolve in a short while, and throat lozenges and salt water gargle help.
There may be a few rare complications such as