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Esophageal Manometry Testing

What is esophageal manometry?

The function of the esophagus is to propel food from the throat to the stomach and prevent reverse passage of food from the stomach to the throat. Esophageal manometry is a test used to measure the function of the esophagus. Three components of the esophagus are assessed (see diagram): the upper valve (upper esophageal sphincter); the lower valve (lower esophageal sphincter); and the propulsive part of the esophagus (the esophageal body).This test is performed to help your doctor determine if:

  • Your esophagus is able to move food to your stomach normally
  • The lower esophageal sphincter is functioning normally to prevent the reflux of the stomach contents in to the esophagus (GERD)
  • The lower esophageal muscle is opening adequately to allow the esophagus to empty (Achalasia)

The manometry test is commonly given to people who have:

  • Difficulty swallowing
  • Pain when swallowing
  • Heartburn
  • Chest pain
  • Chronic cough or hoarseness

The swallowing and digestive processes

To know why you might be experiencing a problem with your digestive system, it helps to understand the swallowing and digestive processes.

When you swallow, food is pushed 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, dysphagia (“sticky” swallowing), odynophagia (painful swallowing) or other problems with swallowing.

The lower esophageal sphincter is the muscular valve that connects the esophagus with the stomach. The lower esophageal sphincter allows food to pass into the stomach when you swallow, but 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 esophageal reflux (GERD). The lower esophageal sphincter may not open or open incompletely causing the esophagus to fill with food and saliva (Achalasia).

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

Special conditions

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

Medications

Please follow the instructions below (unless your doctor gives you other instructions):

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

Preparation

  • Do not eat or drink anything 4 to 6 hours before the test.
  • Do not wear perfume or cologne.

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 (about 1/8 inch in diameter), flexible tube is passed through your nose, down your esophagus and into your stomach. 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. The tube is then slowly withdrawn. Sensors at various locations on the tubing sense the strength of the lower esophageal sphincter. During the test, you will be asked to swallow a small amount of water to evaluate how well the sphincter is working. As the tube is pulled into the esophagus, the sensors measure the strength and coordination of the contractions in the esophagus as you swallow.
  • The test lasts 20 to 30 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.


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