Esophageal Manometry: How Does It Work ?, Digestive Processes, Drug Interaction and Frequently Asked Questions

It is an ambulatory test that is used to identify problems of movement and pressure in the esophagus that can cause problems such as heartburn.

The esophagus is the “food pipe” that goes from the mouth to the stomach. Manometry measures the strength and muscular coordination of your esophagus when you swallow.

The manometry test is commonly administered to people who have:

  • Difficulty to swallow.
  • Pain when swallowing
  • Acidity.
  • Chest pain.

Swallowing and digestive processes

When you swallow, the food goes down your esophagus and reaches the stomach with the help of a wave movement called peristalsis .

Interruptions in this wave movement can cause chest pain or swallowing problems.

In addition, the muscle valve that connects the esophagus to the stomach, called the esophageal sphincter, prevents food and acid from receding from the stomach into the esophagus.

If this valve does not work properly, food and stomach acid can enter the esophagus and cause a condition called gastroesophageal reflux (GERD).

Manometry will indicate not only how well the esophagus can move food down the esophagus, but also how well the esophageal sphincter is working to prevent reflux.

During the manometry test, a thin, pressure-sensitive tube is passed through the nose, along the back of the throat, through the esophagus, and into the stomach.

How does esophageal manometry work?

Your esophagus moves food from your throat to your stomach with a wave motion called peristalsis. Manometry will indicate how well the esophagus can perform peristalsis.

Manometry also allows the doctor to examine the muscle valve that connects the esophagus to the stomach, called the lower esophageal sphincter. This valve relaxes to allow food and fluid to enter the stomach.

It closes to prevent food and fluid from leaving the stomach and up the esophagus.

Abnormalities with peristalsis and function can cause symptoms such as difficulty swallowing, heartburn, or chest pain.

The information obtained from manometry can help doctors identify the problem. The information is also very important for surgery to treat reflux.

What happens before the esophageal manometry test?

Before having an esophageal manometry test, be sure to tell your doctor if you are pregnant, have lung or heart problems, have other medical problems or illnesses, or if you are allergic to any medications.

Can I continue taking medication before esophageal manometry?

There are some medications that can interfere with esophageal manometry:

  • Proton pump inhibitors (Rabeprazol [Aciphex], Dexlansoprazole [Dexilant], Esomeprazole [Nexium], Lansoprazole [Prevacid], Omeprazole [Prilosec] and Pantoprazole [Protonix].
  • H2 blockers (such as Famotidine [Pepcid] and Ranitidine [Zantac]).
  • Antacids (such as Tums and Maalox).
  • Calcium channel blockers (such as Nifedipine [Procardia] and Diltiazem [Cardizem]).
  • Nitrate medications (such as isosorbide dinitrate [Isordil] and nitroglycerin).
  • Beta-blockers (such as Propranolol [Inderal] and Nadolol [Corgard]) Caffeine.

It is very important to talk to your doctor about all the medications you are taking before your test. Do not stop taking any medication without first talking to your doctor.

Can I eat or drink before the procedure?

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

What happens during an esophageal manometry?

A topical anesthetic (medicine to relieve pain) may be applied to your nose to make the passage of the tube more comfortable. A small flexible tube is passed through the nose, esophagus and stomach. The tube does not interfere with your breathing. You’re sitting while the tube is inserted.

The tube is connected to a machine that records the contractions of the esophageal muscles in a graph.

You may feel some discomfort as the tube is placed, but it takes only about a minute to place the tube.

Most patients adjust quickly to the presence of the tube. Vomiting and coughing are possible when the tube is placed, but they are rare. After inserting the tube, you are asked to lie on your left side. A small sensor registers every time you swallow.

During the test, you will be asked to swallow water at certain times. The tube is removed slowly.

The gastroenterologist (a doctor who specializes in the conditions of the gastrointestinal tract) will interpret the esophageal contractions that were recorded during the test. The test lasts 30 to 40 minutes.

What happens next?

You can resume your diet and normal activities after an esophageal manometry. You may feel a temporary pain in your throat. Pills or gargling with salt water can help. A warning about esophageal manometry

If you have any unusual symptoms or side effects after an esophageal manometry, call your doctor or go immediately to the emergency room.