Esophageal manometry

Esophageal manometry, also called motility testing, measures whether the esophagus is working properly. The esophagus should make muscle contractions to push food down to the stomach. Muscular valves (sphincters) at the top and bottom of the esophagus open to let food through, and close to keep it from coming back up. Problems with any of these functions can cause symptoms including trouble swallowing and food backing up into the throat (regurgitation).

Problems that can be detected with esophageal manometry include:

• Achalasia: When the muscle (sphincter) in the lower esophagus doesn’t relax enough to let food pass through to the stomach, and when other muscles in the esophagus are weak. It causes trouble swallowing and regurgitation.
  
• Diffuse esophageal spasm (DES): While some swallowing problems (dysphagia) are caused by blockages and inflammation and aren’t diagnosed with manometry, this rare swallowing problem occurs when normal contractions of the esophagus become irregular.
• Heartburn: Burning feeling in the chest, usually after eating, that happens when stomach acid backs up into the esophagus because the muscle (sphincter) in the lower esophagus doesn’t close properly.
  
• Scleroderma: Rare disease that can cause the muscles in the lower esophagus to stop moving, causing severe gastroesophageal reflux (GERD).
• Hiatal hernia: When part of the stomach bulges above the diaphragm (muscle that's just above the abdomen).

What to expect from esophageal manometry

Before you have an esophageal manometry, you may be asked to fast for a set period. You might also need to avoid taking certain medications. Before the procedure, your nurse puts numbing medication in your nose to make you more comfortable. Then, a thin, flexible tube (catheter) is inserted through your nose, down your esophagus and into your stomach. The end of the tube sticking out of your nose is connected to a machine that measures the functions of your esophagus. After the tube is in place, your doctor or nurse will ask you to swallow bits of water to measure how your esophagus is working and go through a series of dry, wet and possibly jello-like swallows.

Recovery from esophageal manometry

The whole test takes 30 to 60 minutes. Afterward, your nose might feel stuffy and your throat might feel irritated.