Esophageal Manometry

Esophageal Manometry

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Video: M. Jonathan Bern, M.D. demonstrates how a manometry catheter is placed through the nose and into the esophagus.

Esophageal manometry is a test to measure how well the esophagus is working.

During esophageal manometry, a thin, pressure-sensitive tube is passed through your nose down the esophagus and into your stomach.

Before the procedure, you receive numbing medicine inside the nose. This helps make the insertion of the tube less uncomfortable. After the tube is in the stomach, the tube is pulled slowly back into your esophagus. At this time, you are asked to swallow. The pressure of the muscle contractions is measured along several sections of the tube.

While the tube is in place, other studies of your esophagus may be done. The tube is removed after the tests are completed. The test takes about 1 hour.

You should not have anything to eat or drink for 8 hours before the test. If you have the test in the morning, do not eat or drink after midnight.

Tell your health care provider about all medicines you are taking. These include vitamins, herbs, and other over-the-counter medicines. You may have a gagging sensation and some discomfort when the tube is passes through your nose and throat.

The esophagus is the tube that carries food from your mouth into the stomach. When you swallow, muscles in your esophagus squeeze (contract) to push food toward the stomach. Valves, or sphincters, inside the esophagus open to let food and liquid through.

They then close to prevent food, fluids, and stomach acid from moving backward. The sphincter at the bottom of the esophagus is called the lower esophageal sphincter, or LES.

Esophageal manometry is done to see if the esophagus is contracting and relaxing properly. The test helps diagnose swallowing problems (dysphagia, including achalasia), pre-operative evaluation before anti-reflux surgery, and to locate the lower esophageal sphincter prior to pH/impedance testing.

During the test, the doctor can also check the LES to see if it opens and closes properly.

The test may be ordered if you have symptoms of:

  • Heartburn or nausea after eating (gastroesophageal reflux disease, or GERD (link to conditions page))
  • Problems swallowing (feeling like food is stuck behind the breast bone)

Normal results:

The LES pressure and muscle contractions are normal when you swallow.

Abnormal results may indicate:

  • A problem with the esophagus that affects its ability to move food toward the stomach (achalasia)
  • A weak LES, which causes heartburn (GERD)
  • Abnormal contractions of the esophagus muscles that do not move food effectively to the stomach (esophageal spasm)

REFERENCES

  1. Richter JE, Friedenberg FK. Gastroesophageal reflux disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Elsevier Saunders; 2010:chap 43.
  2. Vaezi MF. The esophagus: anatomy, physiology, and diseases. In: Flint PW, Haughey BH, Lund VJ, et al., eds. Cummings Otolaryngology Head and Neck Surgery. 5th ed. Philadelphia, Pa: Elsevier Mosby; 2010:chap 72.