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Acid Reflux Test - Esophageal Manometry

Esophageal manometry is an outpatient test used to identify problems with movement and pressure in the esophagus that may lead to problems like acid reflux.

This test will tell your doctor if your esophagus is able to move food to your stomach normally. Your esophagus moves food from your throat down to your stomach with a wave-like motion called peristalsis. Manometry will indicate how well the esophagus can perform peristalsis.

Manometry also allows the doctor to examine the muscular valve connecting the esophagus with the stomach, called the lower esophageal sphincter, or LES. This valve relaxes to allow food and liquid to enter the stomach. It closes to prevent food and liquid from moving out of the stomach and back up the esophagus.

How to Prepare for the Test

Do not eat or drink anything eight hours before an esophageal manometry.

How the Test is Done

You are not sedated during an esophageal manometry, although a topical anesthetic (pain-relieving medication) may be applied to your nose to make the passage of the tube more comfortable.

A small, flexible tube is passed through your nose, down your esophagus, and into your stomach. The tube does not interfere with your breathing. You are seated while the tube is inserted. The tube is connected to a machine that records the contractions of the esophageal muscles on a graph.

After the tube is inserted, you are asked to lie on your left side.
A small sensor records each time you swallow. During the test you will be asked to swallow water at certain times.

The tube is then slowly withdrawn. The gastroenterologist (a doctor who specializes in conditions of the gastrointestinal tract) will interpret the esophageal contractions that were recorded during the test.

The test lasts from 30 to 40 minutes.

How the Test Will Feel

You may feel some discomfort as the tube is being placed, but it takes only about a minute to place the tube. Most patients quickly adjust to the tube's presence. Vomiting and coughing are possible when the tube is being placed, but are rare.

Possible Risks and Complications from the Test

The tube in the esophagus may cause increased salivation, which raises your risk for aspiration. This can lead to lung injury or aspiration pneumonia. In general, people with swallowing difficulty are at higher risk for aspiration.

Interpreting the Results

Manometry is useful for the following situations:

  • To determine if a GERD patient would benefit from surgery, by measuring pressure exerted by the lower esophageal sphincter muscles.
  • To detect impaired stomach motility (an inability of the muscles to contract normally), which cannot be surgically corrected with standard procedures.
  • To determine if impaired peristalsis or other motor abnormalities are causing chest pain in people with GERD who have these symptoms.

A high definition manometry movie of the esophagogastric junction in a subject with a hiatal hernia.

By Mortin - Copyright 2009
Last modification 31/12/2009

Acid Reflux Test - Esophageal Manometry References