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September 9, 2015

Esophageal Manometry

What is an esophageal manometry?

Problems of swallowing, chest pain, stubborn heartburn and others sometimes result from esophagus diseases which require learning about the muscle and nerve functions of the esophagus, analyzing the “motility” (contraction or peristalsis patterns) and learning if there are abnormal levels of stomach acid in the esophagus. Manometry measures pressures; pH testing measures acidity; impedance examines how fluid passes up and down the esophagus. .

How do I prepare for my procedure?

Prior to an esophageal manometry, a short period with an empty stomach is necessary but your clinician will get you specific instructions. Sometimes certain medications are stopped for a period of time before the testing. If you take any kind of acid blocker medicine be sure to know if this should be stopped ahead of time or continued as usual. Special diets ahead of time are not needed. If you are being referred by another gastroenterologist just for this testing, ordinarily our physician needs to see the records of that physician before doing the special tests.

How is the procedure performed?

Procedures are usually done at the hospital outpatient GI lab. The nurse passes a small flexible catheter back through the nose and throat and down into the esophagus as you take small swallows to assist the passage. Brief discomfort from this passes very quickly. The catheter is attached to a computer that records pressure and other data from in side you. The manometry part of the procedure involves swallowing small sips of water while lying on your back. If a 24 hour pH (acid) and/or impedance (fluid passage) test is to be done, the one catheter is removed and a separate catheter is passed, and the catheter is attached to a recording device that is like a pager that will attach to your belt or be kept on an article of clothing. The manometry itself takes about 20 minutes to do. For the 24 hour tests you go home with the nasal catheter in place, have your usual meals, do normal activity and record notes in a diary about meal times and about symptoms like chest pain or heartburn that you might have. You return to the lab the next day to have the catheter removed. The physician ordinarily supervises the manometry and will take the data from the tests and interpret the information, prepare a report and report your results to you and your referring physician.

How long does the procedure take?

The esophageal manometry will take roughly around 30 minutes to 1 hour at the unit. You can drive yourself home.

What can I expect after my procedure?

When your esophageal manometry is complete, you may return to your normal activities. There should be no side effects to the procedure.

When will I know the outcome of the esophageal manometry?

Your referring doctor will receive the results of your esophageal testing usually with a few days. Advise about your condition then would be conveyed to you by the physician who arranged for you to have the testing, if this is different from the physician performing or supervising the testing.

What are the risks involved with the procedure?

Risks of this test include (most are rare) slight nosebleeds, sore throat or gagging when the tube passes into your throat.

What are my alternatives to this procedure?

There are no good alternatives to esophageal manometry or the other tests. Esophageal manometry is usually performed after anatomic abnormalities have been ruled out by endoscopy. The function of the muscles of the esophagus and the working of the esophageal sphincter may be assessed initially by performing a barium swallow. However, a normal barium swallow will not rule out any abnormal function of the muscles of the esophagus or the esophageal sphincter. Hence, there is truly no good alternatives to the esophageal manometry, pH or impedance tests.

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