Esophageal Manometry: What It Is, What To Expect, Results

Overview

• Esophageal Manometry: A test to measure esophageal motility (motor function) and the pressure produced by esophageal muscles.
• Purpose: To determine if the esophagus can move food to the stomach normally and detect esophageal motility disorders.
• Indicators for Test: Swallowing issues, unexplained regurgitation, chronic acid reflux, heartburn, or noncardiac chest pain.

Why Esophageal Manometry is Needed

• Symptoms Indicating Test:
  • Difficult or painful swallowing
  • Regurgitation
  • Chronic acid reflux unresponsive to medication
  • Heartburn or chest pain not related to the heart
• Possible Diagnoses:
  • Achalasia
  • Scleroderma
  • Esophageal spasms
  • Rumination syndrome

Test Details

• Procedure:
  • High-resolution manometry involves a catheter with pressure sensors placed inside the esophagus.
  • Sensors measure muscle contractions during swallowing and produce an esophageal pressure topography map.
• Preparation:
  • Avoid food/drink for 6 hours prior.
  • Discontinue certain medications like calcium channel blockers, nitrates, opioids, and sedatives 24 hours before the test.
• Sedation and Discomfort:
  • Typically not sedated; local anesthesia used to numb throat.
  • Some discomfort with catheter placement.

How the Test is Done

• The catheter is inserted through the nasal cavity to the stomach.
• Test involves swallowing sips of water while lying down.
• Baseline readings taken, followed by multiple swallows.
• Variations may include changes in position or substances swallowed.

Potential Risks

• Minor risks include coughing, choking, or gagging during catheter insertion.
• Rare cases of nosebleeds.

Results and Follow-Up

• Interpreting Results:
  • Measures muscle contraction strength and coordination.
  • Identifies abnormalities such as hypertensive peristalsis, weak peristalsis, reduced distal latency, and abnormal LES relaxation.
• Impact on Treatment:
  • Results guide appropriate treatment strategies.
  • Confirms safety and efficacy of potential treatments like anti-reflux surgery.

Additional Common Questions

• Comparison with Barium Swallow Test:
  • Barium swallow is an imaging test; manometry measures mechanical activity.
  • Manometry often follows a barium swallow to investigate further mechanical issues.

Notes

• Esophageal manometry is crucial for diagnosing and treating esophageal functional issues, aiding in the development of targeted treatment plans.
• Conducted at Cleveland Clinic and other locations; results can inform treatments such as surgery.