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Esophageal manometryBy Mayo Clinic staff
Original Article: http://www.mayoclinic.com/health/esophageal-manometry/MY01208
Esophageal manometry (muh-NOM-uh-tree) is a test that gauges how well your esophagus works. Your esophagus is the long, muscular tube that connects your throat to your stomach. Esophageal manometry measures the rhythmic muscle contractions (peristalsis) that occur in your esophagus when you swallow. Esophageal manometry also measures the coordination and force exerted by the muscles of your esophagus.
During esophageal manometry, a thin, flexible tube (catheter) that contains sensors is passed through your nose, down your esophagus and into your stomach. Esophageal manometry can be helpful in diagnosing some mostly uncommon disorders that affect your esophagus.
Why it's done
Esophageal manometry is used to evaluate the movement (motility) of food through the esophagus and into the stomach. The test measures how well the circular bands of muscle (sphincters) at the top and bottom of your esophagus open and close, as well as the pressure, strength and pattern of the wave of esophageal muscle contractions that moves food along.
Your doctor may recommend esophageal manometry if you're experiencing symptoms that could be related to an esophageal disorder. Those symptoms may include:
- Difficulty swallowing (dysphagia)
- Pain when swallowing (odynophagia)
Esophageal manometry may be used to help diagnose a number of conditions:
- Swallowing problems (dysphagia). Swallowing problems are more likely to be caused by such things as blockages, narrowing (strictures) or inflammation than by motility issues, so those causes should be ruled out by other tests before resorting to manometry. Diffuse esophageal spasm is a rare swallowing problem that can be identified by manometry. It is defined by multiple, forceful, poorly coordinated muscle contractions of your esophagus.
- Achalasia. This uncommon condition occurs when your lower esophageal muscle (sphincter) doesn't relax properly to let food enter your stomach. Muscles in the wall of your esophagus are often weak as well. This can cause difficulty swallowing and regurgitation of food back up into your throat.
- Scleroderma. In many people with this rare progressive disease, the muscles in the lower esophagus cease to move, leading to severe gastroesophageal reflux.
If you're considering undergoing anti-reflux surgery to treat gastroesophageal reflux disease (GERD), esophageal manometry may be recommended to make sure you don't have achalasia or spasm, which won't be helped by GERD surgery.
If you have chest pain not related to your heart, esophageal manometry is generally only recommended if you've had an endoscopy, GERD has been ruled out and you have some swallowing issues.
Esophageal manometry is generally safe, and complications are rare. But as with any medical procedure, it does carry a risk of complications.
During esophageal manometry, you may experience:
- Gagging when the tube passes into your throat
- Watery eyes
- Slight nosebleed
- Discomfort in your nose and throat
After esophageal manometry, you may have some mild side effects, including:
- Sore throat
- Stuffy nose
- Minor nosebleed
Rarely, severe complications may include:
- Irregular heartbeat
- Stomach contents flowing back into your esophagus, which you breathe into your lungs (aspiration)
- A hole in your esophagus (perforation)
How you prepare
You may need to avoid eating and drinking for a certain length of time before esophageal manometry. Your doctor will give you specific instructions. Also, tell your doctor about any medications you're taking. You may be asked not to take some medications before the test.
What you can expect
Esophageal manometry is an outpatient procedure done without sedation. Most people tolerate it well. You may be asked to change into a hospital gown before the test starts.
During esophageal manometry
- While you are sitting up, a member of your health care team sprays your throat with a numbing medication or puts numbing gel in your nose or both.
- A catheter is guided through your nose into your esophagus. The catheter may be sheathed in a water-filled sleeve. It doesn't interfere with your breathing. However, your eyes may water, and you may gag. You may have a slight nosebleed from irritation.
- After the catheter is in place, you may be asked to lie on your back on an exam table, or you may be asked to remain seated.
- You then swallow small sips of water. As you do, a computer connected to the catheter records the pressure, strength and pattern of your esophageal muscle contractions.
- During the test, you'll be asked to breathe slowly and smoothly, remain as still as possible, and swallow only when you're asked to do so.
- A member of your health care team may move the catheter down into your stomach while the catheter continues its measurements.
- The catheter then is slowly withdrawn.
The test usually lasts 20 to 30 minutes.
After esophageal manometry
When your esophageal manometry is complete, you may return to your normal activities.
The results of your esophageal manometry will be sent to your doctor. Generally, results are ready in one to two days. The test results may be used to guide further treatment if necessary or to help plan a surgical procedure if the test was part of a preoperative evaluation. Plan to discuss the results with your doctor at a follow-up appointment.
- Understanding esophageal manometry. American Society for Gastronintestinal Endoscopy. http://www.asge.org/PatientInfoIndex.aspx?id=6822. Accessed April 23, 2012.
- Lembo AJ et al. Motility testing: When does it help? http://www.uptodate.com/index. Accessed April 23, 2012.
- American Gastroenterological Association. AGA technical review on the clinical use of esophageal manometry. Gastroenterology. 2005;128:209.
- Ask Mayo Expert. Esophageal manometry. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.
- Falk GW et al. Goldman: Goldman's Cecil Medicine. 24th ed. Saunders, Elsevier, 2011. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-1-4377-1604-7..00140-8&isbn=978-1-4377-1604-7&sid=1300780111&uniqId=331154314-3#4-u1.0-B978-1-4377-1604-7..00140-8--s0050