Esophageal manometry is a test that analyses how well the esophagus is functioning in the body. The esophagus, also commonly referred to as the food pipe, is a muscular tube that extends from the back of the throat i.e. pharynx to the stomach via the diaphragm. Being approximately 8 inches long in adults, the esophagus is lined by moist pink tissue known as mucosa and carries out vital tasks to ensure digestive health in the system.
Upon swallowing food, the esophagus performs the key function of carrying the particles into the stomach for proper digestion. It also prevents the backward flow of assimilated foods and acids (acid reflux) into the throat and mouth, as well as averts the passage of food down the windpipe or trachea, thereby preventing choking, vomiting. These operations are facilitated by means of two muscle groups in the food pipe – the upper esophageal sphincter (UES) – a bundle of muscles situated at the top end of the esophagus and the lower esophageal sphincter (LES) – a cluster of muscles located at the base of the esophagus, at the junction where it affixes to the stomach.
The esophageal manometry test measures the muscle contractions of the UES and LES as the esophagus constricts itself to push the food from the mouth to the stomach. It is also used to determine the force, speed and coordination of the esophageal muscles as they carry food down to the stomach. This diagnostic evaluation is very useful in diagnosing problems in the esophagus, especially when people report difficulty swallowing, chest pain or heartburn.
Why It Is Done:
The esophageal manometry test is recommended by the doctor if the patient displays symptoms associated with disorders of the food pipe, such as:
- Difficulty swallowing, with pain while ingesting food past the throat
- Regurgitation i.e. reverse flow of food back into the mouth, along with heartburn – an uneasy burning sensation in the chest and throat
- Chest pain
Moreover, if the person primarily experiences inability to swallow food smoothly, the doctor conducts other tests such as an X-ray or gastroscopy/upper endoscopy, before doing an esophageal manometry, to spot or rule out any narrowing, complete blockage or inflammation in the esophagus.
Esophageal manometry is also useful in diagnosing various disorders arising in the food pipe, including diffuse esophageal spasm, scleroderma, achalasia – all of which involve defective functioning of the esophageal sphincter muscles leading to incapacity to swallow food, regurgitation and gastroesophageal reflux disease (GERD).
Prior to the procedure, the doctor instructs the patient to not consume food for 8 hours and also to stop taking any other prescription medications that may interfere with the manometry test protocol and results.
The esophageal manometry test is performed as an outpatient procedure without the requirement for any anaesthesia/sedation in a well-equipped hospital by the chief medical practitioner. After the patient changes into a loose-fitting clean hospital gown, a numbing gel or medication is sprayed down their throat while they seated erect on the exam table/bed. A catheter – a thin flexible tube affixed with pressure sensors, is then guided via the nose into the esophagus, which might make the eyes water a little or trigger minor nosebleeds, irritation, but does not affect breathing. The patient is then told to lie on their back on the exam bed/table, or continue to remain sitting, depending upon the requirements of the manometry test. Next, when the patient is taking in small sips of water, the computer connected to the catheter records the speed, pressure and pattern of esophageal muscle contractions.
During the course of the manometry test, the patient is asked to breathe in slowly, smoothly without interruptions, breaks and deeply, remain still without moving the body much and swallow water only when instructed to do so by the doctor. Once the necessary measurements are obtained upon moving the catheter within the esophagus - both upwards and down till the stomach, the thin tube is withdrawn.
The entire procedure takes about 30 minutes and the patient can resume normal activities at home and work after the esophageal manometry is completed.
The esophageal manometry test is usually a safe protocol without any grave health complications. However, minor discomfort is encountered during the diagnostic procedure, such as:
- Gagging when the catheter tube is inserted past the throat
- Watery eyes
- Uneasiness in the nose and throat
Mild side-effects are witnessed upon completion of the esophageal manometry procedure, including:
- Sore throat
- Stuffy nose
- Minor nosebleed
The results of the esophageal manometry test are obtained within 1 – 2 days post the procedure. Based on the pattern and pressure of esophageal muscle contractions recorded in the manometry test, the doctor informs the patient of the relevant esophageal disorder, with its symptoms and treatment, or advises them regarding any surgery they may have to undergo, with regular follow-up consultations to monitor esophagus functions and digestive health of the patient.