What Is Esophageal Manometry?

    Your esophagus is the tube that connects your throat to your stomach. Each time you swallow the muscles in your esophagus contract. This pushes the food you eat into your stomach.

    A valve at the bottom of your esophagus called the lower esophageal sphincter (LES) prevents the contents of your stomach from moving back up the esophagus. If the valve does not work properly, your stomach contents can re-enter the esophagus. This leads to acid reflux, heartburn, and gastroesophageal reflux disease (GERD).

    Esophageal manometry can help diagnose problems with swallowing or the LES.

    Esophageal Manometry Procedure

    Your doctor will use a numbing cream inside your nose. This makes the procedure more comfortable.

    Next, he or she will insert a thin tube through your nose. This tube goes down your esophagus and into your stomach. It is flexible and lubricated to help pass easily through your nose and esophagus.

    The doctor will then pull the tube back out very slowly. You will be asked to swallow at different times as the tube is pulled out. Sensors are located at various points on the tube. These measure the strength of your esophageal muscles and LES.

    How Esophageal Manometry Feels

    As the tube goes down your throat, you may feel like gagging or other discomfort. For example:

    • your eyes may water
    • your nose may bleed slightly
    • you might salivate more than usual

    In rare cases, you may cough or vomit as the tube is being placed. Positioning the tube only takes about a minute. The test should feel less uncomfortable after that. You will probably adjust quickly to the tube’s presence.

    You will still be able to breathe normally once the tube is placed through your nose.

    Why Doctors Perform Esophageal Manometry

    Your doctor may order this test if he or she suspects a problem with your esophagus or LES. Symptoms that may prompt testing include:

    • acid reflux
    • chest pain
    • feeling that food gets stuck in your chest
    • heartburn

    Understanding Esophageal Manometry Results

    A normal result means that your LES and esophageal muscles are working properly.

    An abnormal result suggests a problem with your esophagus or LES. Possible problems include:

    • abnormal contractions of the muscles in your esophagus
    • achalasia (a condition in which your LES does not open properly to allow food to pass through)
    • hypertensive LES
    • esophageal spasm
    • nutcracker esophagus (a condition in which swallowing contractions are too powerful)
    • weak LES

    Risks of Esophageal Manometry

    You might experience slight discomfort after the test. Common complications include:

    • sore throat
    • stuffy nose

    These mild symptoms usually clear up within several hours. Call your doctor if you have any concerns.

    In rare cases, you may develop serious problems, such as perforation. This means that the tube made a hole in your esophagus.

    Another rare complication is aspiration, inhaling something that you shouldn’t have, such as saliva or the contents of your stomach. Aspiration can lead to pneumonia or lung injury and is more common in people with difficulty swallowing.

    Preparing for Esophageal Manometry

    You must fast before your procedure. Times vary, but range from six hours to overnight. Consult your doctor for specific instructions.

    Tell your doctor about all of your medications. You may need to stop taking them temporarily before your test. Some medications that can affect the results of the test include:

    • calcium channel blockers
    • nitrate products
    • nitroglycerin products
    • sedatives