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Diagnostics & Testing

Diagnosis - Esophageal Manometry Test

What is esophageal manometry?

Esophageal manometry is a test used to measure the function of the lower esophageal sphincter (the valve that prevents reflux of gastric acid into the esophagus) and the muscles of the esophagus (see diagram). This test will tell your doctor if your esophagus is able to move food to your stomach normally. To know why you might be experiencing a problem with your digestive system, it helps to understand the swallowing and digestive processes.

The manometry test is commonly given to people who have:

  • Difficulty swallowing
  • Pain when swallowing
  • Heartburn
  • Chest pain

The swallowing and digestive processes

When you swallow, food moves down your esophagus and into your stomach with the assistance of a wave-like motion called peristalsis. Disruptions in this wave-like motion may cause chest pain or problems with swallowing.

In addition, the muscular valve connecting the esophagus with the stomach, called the esophageal sphincter, prevents food and acid from backing up out of the stomach into the esophagus. If this valve does not work properly, food and stomach acids can enter the esophagus and cause a condition called gastroesophageal reflux disease (GERD).

Manometry will indicate not only how well the esophagus is able to move food down the esophagus but also how well the esophageal sphincter is working to prevent reflux.

Before the test

Special conditions

Tell the physician if you have a lung or heart condition, have any other diseases, or have allergies to any medications

Medications

Please follow the instructions below (unless told otherwise by your doctor):

  • One day (24 hours) before the test, stop taking calcium channel blockers such as Calan®, Isoptin® (verapamil); Adalat®, Pro-cardia® (nifedipine); and Cardizem®(diltiazem). Also stop taking nitrate and nitroglycerin products such as Isordil® (isosorbide); Nitrobid®, Nitrodisc®, Nitrodur®, Nitrogard®, Transderm-Nitro®, and Tridil®
  • Twelve hours before the test, do not take sedatives such as Valium® (diazepam) or Xanax® (alprazolam)
  • Do not stop taking any other medication without first talking with your doctor.

Day of test

Eating and drinking
  • Do not eat or drink anything 4 to 6 hours before the test.
During the test
  • You are not sedated. However, a topical anesthetic (pain-relieving medication) will 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. This tube is a high-resolution manometry catheter that is about 4 mm in diameter. The tube does not interfere with your breathing. You will be seated while the tube is inserted.
  • 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 will be asked to lie on your left side. The end of the tube exiting your nose is connected to a machine that records the pressure exerted on the tube. Sensors at various locations on the tubing sense the strength of the lower esophageal sphincter and muscles of the esophagus. During the test, you will be asked to swallow a small amount of water to evaluate how well the sphincter and muscles are working. The sensors also measure the strength and coordination of the contractions in the esophagus as you swallow.
  • The test lasts 10 to 15 minutes. When the test is over, the tube is removed. The gastroenterologist will interpret the recordings that were made during the test.

After the test

  • Your physician will notify you when the test results are available or will discuss the results with you at your next scheduled appointment.
  • You may resume your normal diet and activities and any medications that were withheld for this test.
  • You may feel a temporary soreness in your throat. Lozenges or gargling with salt water may help.
  • If you think you may be experiencing any unusual symptoms or side effects, call your doctor.
References:

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 10/18/2012...#4952