What Everybody Ought To Know About Esophageal Manometry

Your doctor suggested an esophageal manometry test and like most people, you are not familiar with it.

It sounds rather intimidating and you might wonder why exactly you have to go for this test and better still: Is it painful?

So, what is Esophageal manometry?

An esophageal manometry test measure the power and peristaltic movement  (motility) of the esophagus by obtaining a computerized recording of the relaxation and contraction of the upper and lower esophageal sphincters while you swallow.

Although it is not a first line diagnostic test, it may be performed as a pre-operative assessment when undergoing anti-reflux surgery. The test also assists in determining specific treatment needed in esophageal motility disorders.

Motility disorders include esophageal spasms (irregular, painful contractions of the esophagus) and achalasia (the absence of esophageal peristalsis and impaired relaxation of the lower esophageal sphincter in response to swallowing).

 

How is the test performed and what can I expect?

A qualified nursing Sister will perform the test. The procedure is not painful but you might experience mild discomfort. A thin, flexible catheter is inserted through the nose into the the esophagus. This catheter contains sensors that gather information electronically throughout the study.

You will be seated on an examination bed for the insertion of the nasal catheter. A local anesthetic spray is used to numb the throat and nostril. The spray has a bad taste but relief the discomfort from the insertion of the thin, lubricated catheter.

While the tube is inserted your eyes will become watery due to the irritation. As the tube reaches the back of your throat, you might gag and cough for a brief moment. This part of the study can get uncomfortable and concentrating on your breathing will help. You will be asked to “swallow” the tube and sips of water through a straw can assist in swallowing it down. This swallowing sensation will feel like swallowing unchewed food.

You will now be assisted to lie down on your back.

It takes a minute or two to get comfortable and get used to the catheter in the throat. You will be able to breathe, swallow and talk with ease. The test can now be started and the nursing Sister will ask you to relax, not to speak and limit spontaneous swallows for 3 to 5 minutes.

At this stage, pressing your tongue against your pallet and concentrating on your breathing, will help you to limit spontaneous swallows. This is an important part of the study where the resting pressure of the lower esophageal sphincter is monitored and swallows, coughing or speaking will affect the pressure. Once the resting pressure is recorded, you will be given sips of water through a syringe to swallow. These are called wet swallows and peristaltic movements are captured with each swallow. A set of 10 wet swallows are performed and recorded.

After the test, the tube will be removed by slowly pulling it out through the nose. Your nose may be watery due to the irritation and lubrication and you can gently blow your nose. Sometimes a little bleeding may occur. You might experience a sore throat afterwards. Taking lozenges or gargling with salt water may alleviate the discomfort.

The recording will now be analyzed and a report will be available to the referring doctor on the same day.

 

How do I prepare for the test?

  • You should fast 6 hours prior to the study.
  • The duration of the test is 30 – 4 5 minutes.
  • You are allowed to drive and continue with normal daily activities afterwards.
  • Your doctor will advise you on which chronic medication to stop, if any, prior to the study.
  • The study is done by appointment and authorization from the medical aid is compulsory.

 

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