Esophageal manometry, also called esophageal motility testing or esophageal function testing, measures the pressure and coordination of the muscles of the lower esophageal sphincter and esophageal body during swallowing, using a thin catheter with multiple sensors along its length. Dr. Harary performs high-resolution esophageal manometry, which is the most modern version of this test.
Esophageal manometry is one of the most useful tests to evaluate swallowing disorders. Esophageal manometry can also be used to evaluate chest pain felt to be originating from the esophagus, as an additional test before doing ambulatory esophageal reflux pH monitoring, and before anti-reflux surgery is done.
First, the nostril is numbed using a local anesthetic gel. Then, while taking small sips of water, a thin, lubricated recording catheter is passed through the nostril into the back of the nose and throat and then into the esophagus. There may be an irritated feeling of the nose and slight gagging during the passage of the esophageal manometry catheter, but it usually lasts for 1 minute or less. Once the tube is in place, the patient will be given sips of water to swallow so the muscular contractions can be observed by the pressure sensors in the catheter. One can breathe and speak normally during the test. No sedation is required, the test lasts about 20-30 minutes, and the patient can eat normally and go to work immediately after the esophageal manometry is completed. It is a safe procedure, and serious complications are extremely rare. Once the esophageal manometry has been analyzed, Dr. Harary will meet with the patient in his New York City office to discuss the test results and create a customized treatment plan.
In order to prepare for the esophageal manometry, you should not eat solid foods for 6 hours or drink anything for 3 hours before the test, as the stomach should be empty. Since many medications can affect the esophagus pressure and muscle contractions, you should discuss with your gastroenterologist each medication that you are taking. Your gastroenterologist may have you temporarily stop one or more of your medications before your test.
Frequently, ambulatory esophageal reflux pH monitoring is done immediately after the esophageal manometry, using a thinner tube passed through the same nostril. This adds an additional 10 minutes to the test time. If this test is done, you will spend the next 24 hours with a very thin catheter leading from your nostril to a small recording box that you carry on a shoulder strap or belt clip.
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