Esophageal manometry is an outpatient test used to identify problems with movement and pressure in the esophagus that may lead to problems like heartburn. The esophagus is the "food pipe" leading from the mouth to the stomach. Manometry measures the strength and muscle coordination of your esophagus when you swallow.
During the manometry test, a thin, pressure-sensitive tube is passed through the nose, along the back of the throat, down the esophagus, and into the stomach.
Who Would Get Esophageal Manometry?
The esophageal manometry test may be given to people who have the following conditions:
- Difficulty swallowing
- Heartburn or reflux
- Non-cardiac Chest pain
- Prior to anti- reflux surgery
How Does Esophageal Manometry Work?
Your esophagus moves food from your throat down to your stomach with a wave-like motion called peristalsis. Manometry will indicate how well the esophagus can perform peristalsis. Manometry also allows the doctor to examine the muscular valve connecting the esophagus with the stomach, called the lower esophageal sphincter, or LES. This valve relaxes to allow food and liquid to enter the stomach. It closes to prevent food and liquid from moving out of the stomach and back up the esophagus.
Abnormalities with peristalsis and LES function may cause symptoms such as swallowing difficulty, heartburn, or chest pain. Information obtained from manometry may help doctors to identify the problem. The information is also very important for surgery to treat reflux.
What Happens Before the Esophageal Manometry Test?
Before you have an esophageal manometry test, be sure to tell the doctor if you are pregnant, have a lung or heart condition, have any other medical problems or diseases, or if you are allergic to any medications.
Can I Continue to Take Medication Before Esophageal Manometry?
There are some medications that may interfere with esophageal manometry.
- Proton pump inhibitors (Rabeprazole [Aciphex], dexlansoprazole [Dexilant], esomeprazole [Nexium], lansoprazole [Prevacid], omeprazole [Prilosec], and pantoprazole [Protonix].
- H2 blockers (such as cimetidine [Tagamet], famotidine [Pepcid] and nizatidine)
- Antacids (such as Tums and Maalox)
- Calcium channel blockers (such as diltiazem [Cardizem] and nifedipine [Procardia])
- Nitrate medications (such as isosorbide dinitrate [Isordil] and nitroglycerin)
- Beta- blockers (such as nadolol [Corgard] and propranolol [Hemangeol, Inderal, LA, InnoPran XL])
It is very important that you talk to your doctor about all drugs you are taking prior to your test. Do not discontinue any medication without first consulting with your doctor.
Can I Eat or Drink Before Esophageal Manometry?
Do not eat or drink anything eight hours before an esophageal manometry.
What Happens During an Esophageal Manometry?
You are not sedated during an esophageal manometry, although a topical anesthetic (pain-relieving medication) may be applied to your nose to make the passage of the tube more comfortable.
A small, flexible tube is passed through your nose, down your esophagus, and into your stomach. The tube does not interfere with your breathing. You are seated while the tube is inserted. The tube is connected to a machine that records the contractions of the esophageal muscles on a graph.
You may feel some discomfort as the tube is being placed, but it takes only about a minute to place the tube. Most patients quickly adjust to the tube's presence. Vomiting and coughing are possible when the tube is being placed, but are rare.
After the tube is inserted, you are asked to lie on your left side.
A small sensor records each time you swallow. During the test, you will be asked to swallow water at certain times.
The tube is then slowly withdrawn. The gastroenterologist (a doctor who specializes in conditions of the gastrointestinal tract) will interpret the esophageal contractions that were recorded during the test.
The test lasts from 30 to 40 minutes.
A Warning About Esophageal Manometry
If you have any unusual symptoms or side effects after an esophageal manometry, call your doctor or go to the emergency room immediately.