Esophageal manometry is a motility test that evaluates the movements, strength and coordination of the esophagus, also referred to as the food pipe. This test measures the progression of food and liquids down the esophagus. It can also measure the strength of the patient’s lower esophageal sphincter (LES), the involuntary muscles that form a valve-like structure at the lower end of the esophagus where it meets the stomach. The LES prevents food, liquid and acid produced in the stomach from backing up into the esophagus.

Esophageal manometry can help the gastroenterologist diagnose certain abnormalities of the esophagus such as disorders of the movement of the esophagus (i.e. achalasia, nutcracker esophagus and diffuse esophageal spasm), a weak LES, a hypertensive LES and ineffective esophageal motility. Patients that present with such abnormalities may experience one or several of the following signs and symptoms: esophageal reflux, heartburn, difficulty swallowing, painful swallowing, a sensation of food getting stuck in the food pipe, non-cardiac chest pain, nausea and vomiting. Patients being evaluated for anti-reflux surgery and a hiatal hernia repair should also undergo an esophageal manometry test to help determine if the patient will benefit from the surgery/repair. Other patients that should consider this test are those who have been diagnosed with Barrett’s esophagus.

The test is painless but may cause minimal discomfort as a thin, flexible catheter with sensors is passed thru the nose and into the esophagus. A topical anesthetic (lidocaine jelly) is used to numb the areas of the nose and to help the catheter pass easily. Some patients experience gagging and tearing up of the eyes during the insertion of the catheter. A minor nosebleed that quickly subsides may also occur. Complications, although extremely rare, include perforation. Once the catheter is in place, the patient is made to swallow small sips of water and the measurements of the esophagus are taken by the pressure sensors. After the procedure, the patient is allowed to return home or to work

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