What Is Esophageal Manometry?

Esophageal manometry is a test used to help diagnose issues with your esophagus or lower esophageal sphincter (LES). 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. The LES is a valve-like ring of muscle at the bottom of your esophagus that prevents the contents of your stomach from moving back up your esophagus.

If the valve doesn’t work properly, your stomach contents can re-enter your esophagus. This leads to acid reflux, heartburn, and gastroesophageal reflux disease (GERD). Esophageal manometry can help diagnose problems with swallowing or with your LES.

Your doctor may order this test if they suspect 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
  • nausea after eating
  • pain or difficulty swallowing

You must fast before your procedure. Fasting times vary, but range from six hours to overnight. You should talk to 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

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

Next, they will insert a thin tube through your nose. This tube goes down your esophagus and into your stomach. It’s 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.

The whole procedure should only take around 15 minutes.

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.

Your doctor will use the information gathered by the sensors on the tube to help diagnose any issues with swallowing or with your LES. They will interpret the information and let you know when the results are available. 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 your swallowing contractions are too powerful
  • scleroderma, an autoimmune disease that can paralyze your esophageal muscles
  • weak LES

Your doctor will discuss your results at your next appointment. If they have found any problems with your LES or esophageal muscles, they may want to schedule follow-up tests or appointments.

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

  • minor nosebleed
  • sore throat
  • stuffy nose

If you have a sore throat after the procedure, you may want to try throat lozenges or gargling with salt water.

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 has made a hole in your esophagus.

Another rare complication is aspiration, or 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.