Understanding Esophageal Testing or Manometry

The esophagus moves food from the mouth to the stomach, and various abnormalities and diseases can develop in the tube and cause serious health risks. However, simpler or temporary problems in the throat might be responsible for your symptoms. Testing is the only way to find out if there are any serious esophageal problems because you can’t self-diagnose these conditions. Esophageal testing or manometry is the kind of test that doctors use to diagnose problems in the esophagus. Your doctor might order this test if you have symptoms such as nausea after eating, frequent acid reflux or heartburn, chest pain, difficulty swallowing or the feeling that food gets stuck in your chest.

What role does the esophagus play?

The esophagus is a tube that connects the stomach and throat and measures about eight inches. The tube runs behind the windpipe and heart and in front of the spine. Covered by moist, pink tissue called mucosa, the esophagus has a ring of muscles at the top and bottom called sphincters that expand and contract to move food along and prevent material from entering the windpipe. Sphincters prevent food from moving back into the throat except when vomiting or acid reflux overrides the lower ring of muscles.

Why do physicians order esophageal testing?

Manometry measures muscle contractions, strength and proper function to determine whether your symptoms are caused by a serious health disorder. Symptoms of esophageal distress range from relatively benign or temporary conditions to debilitating conditions that affect breathing and eating. Mental and psychosomatic problems can also cause similar symptoms, so your doctor orders manometry to determine whether more exhaustive tests are necessary. Further testing might include a CT scan, biopsy, endoscopy or barium-swallow X-ray.

What conditions does manometry help to diagnose?

Esophageal testing helps your doctor or gastroenterologist diagnose congenital problems in the esophagus, tumors, esophageal cancer, gastroesophageal reflux (GERD), Barrett’s esophagus and achalasia, a disorder that weakens the esophagus’ ability to move food. Other conditions that manometry helps to diagnose include:

  • Diffuse esophageal spasm
  • Weak lower esophageal sphincter
  • Esophagitis
  • Esophageal ulcers
  • Narrowing of the esophagus
  • Mallory-Weiss tear
  • Plummer Vinson syndrome
  • Esophageal stricture

Barrett’s esophagus is an escalation of GERD or acid reflux. The condition causes the tissue lining the esophagus to become more like tissue in the small intestine, which increases the risks of developing tumors, ulcers and cancer.

What do I need to do before testing?

Be sure to tell your doctor about all the medicines you’re taking because he or she might ask you to stop taking certain medicines before the test. Some drugs affect esophageal pressure and muscular contractions. You need to refrain from eating and drinking for at least six hours before the test so that you don’t vomit.

What can I expect to happen during the test?

Professional medical staff prepare you for the procedure by applying thin cream inside your nostrils to ease passage of a flexible tube. The doctor or technician then passes the thin tube through the nose, down the esophagus and into the stomach. You might experience some discomfort during insertion, but the tube doesn’t affect your breathing and only takes about a minute to place. Once inserted, the tube causes little discomfort. The end of the tube that protrudes from the nose is attached to a machine that measures the test’s results. The tube is inserting while you are seated, but then you will lie on your side during the test and swallow small sips of water so that the manometer can measure swallowing movement through the esophagus.

The test takes about 30 minutes, and it is important to breathe slowly and remain still. Sensors on the tubing record contractions as the tube is slowly pulled out of your esophagus. Results go immediately to your doctor for further study, and your doctor might discuss the findings immediately or at your next appointment.

Does the test cause any pain or side effects?

Some people gag or salivate when the tube goes down the throat. Your eyes might water, and nosebleeds happen occasionally. Serious side effects rarely occur, but any medical procedure carries some risks. Possible complications include encountering a nasal blockage, misdirection of the tube into the windpipe, aspirating liquids into the lungs from stomach back-flow or experiencing an irregular heartbeat.

Coughing and vomiting are possible but rare, and the procedure rarely causes pain but only minor discomfort. Some medical professionals apply mild topical anesthetics to the inside of noses to make tube passage more comfortable.

  1. You might experience mild soreness in the throat.
  2. Call your doctor if you experience any unusual side effects or reactions.
  3. You can resume normal eating and other activities immediately following the test.
  4. Minor nosebleeds occur occasionally but usually stop within hours.

 

Are there any contraindications associated with esophageal manometry?

Tell your doctor if you are pregnant or have heart disease, breathing problems or other health disorders. Be sure to mention any allergies or intolerances to medications. People who can’t follow instructions, those with severe blood clotting problems and patients with known conditions such as ulcers, strictures, varices and Zenker’s diverticula should not get esophageal testing.

How do the risks of testing compare with the dangers of not getting tested?

Diagnosing esophageal disorders without advanced testing is impossible, and manometry takes little time, causes no lasting pain or discomfort and generates few medical risks. Your doctor or testing facility will take every precaution to ensure your safety. Test results can help to diagnose many dangerous disorders that could prove life-threatening. Early detection of esophageal disorders improves the outlook for treatment and recovery.

Are there any warnings that I should know about?

In rare cases, tubing might be blocked by obstructions in the nasal cavity or esophagus and make completing the test impossible. All medical tests carry risks, so this information should only serve as a general information guide. Always get specific advice about medical procedures from a qualified medical professional.