Esophageal manometry refers to a procedure used to determine how well the muscles of the esophagus and the sphincter valve work by measuring pressure (manometry) generated by the esophageal muscles and the sphincter. The esophagus is a muscular tube that connects the throat to the stomach. With each swallow, the esophagus muscle contracts and pushes food into the stomach. At the lower end of the esophagus, a valve–a special sphincter muscle–remains closed except when food or liquid is swallowed. Sometimes the sphincter muscles do not work correctly and testing is required to diagnose the problem. The most common use for esophageal manometry is to evaluate the lower esophageal sphincter and the muscle of the body of the esophagus in patients who have Gastroesophageal Reflux Disease (GERD). Manometry often can identify weakness in the lower esophageal sphincter that allows stomach acid and contents to back up into the esophagus. It also may identify abnormalities in the functioning of the muscle of the esophageal body that may add to the problem of reflux.
Esophageal Manometry Used to Address:
- Achalasia: This is when the sphincter muscle in the lower esophagus doesn’t relax enough to let food pass through to the stomach, and when other muscles in the esophagus are weak. It causes trouble swallowing and regurgitation.
- Diffuse Esophageal Spasm (DES): While some swallowing problems are caused by blockages and inflammation and aren’t diagnosed with Manometry, this rare swallowing problem occurs when normal contractions of the esophagus become irregular.
- Heart Burn: Heartburn is a burning feeling in the chest, usually after eating, that happens when stomach acid backs up into the esophagus because the sphincter muscle in the lower esophagus doesn’t close properly.
- Scleroderma: This is a rare disease that can cause the muscles in the lower esophagus to stop moving, causing severe Gastroesophageal Reflux.
- Hiatal hernia
Regardless of why a colonoscopy has been recommended for you, there are important steps you can take to prepare for and participate in the procedure:
- Provide a complete list of all the medicines you are taking — including any over-the-counter medications and natural supplements — and any allergies to drugs or other substances.
- Dr. Singh, Dr. Rashbaum, Dr. Nitin Parikh, Dr. Long B. Nguyen, Dr. Jae Kim, Dr. Ruth Montalvo and providers Tammi D’Elena, PA-C; and Vanessa T. Dang, MSN, APRN; will also want to know if you have a heart, lung or other medical condition that may need special attention before, during or after a colonoscopy.
- It is important they know if you are taking diabetic medications or anticoagulants (sometimes called blood thinners) or have bleeding or clotting problems.
- Patients are given instructions in advance that outlines what they should and should not do to prepare for an esophageal manometry.
- Do not eat or drink anything eight hours before an esophageal manometry.
- Check your instructions about what to eat or drink the night before your EM and when to stop eating.
- You will be asked to sign a form which verifies that you consent to have the procedure and that you understand what is involved. If there is anything you don’t understand, ask for more information.
About the Procedure
At the start of the Esophageal Manometry procedure, one nostril is anesthetized with a numbing lubricant. A flexible plastic tube approximately one-eighth inch in diameter is then passed through the anesthetized nostril, down the back of the throat, and into the esophagus. After the tube is inserted, you are asked to lie on your left side and swallow water at certain times as the tube allows pressure generated by the esophageal muscles to be measured (at rest and during swallows) by a machine that records the contractions of the esophageal muscles on a graph. After the test has been completed, the tube is slowly withdrawn. The side effects of Esophageal Manometry are minor and include mild sore throat, nosebleeds, and, uncommonly, sinus problems due to irritation and blockage of the ducts leading from the sinuses and into the nose.
Aftercare and Recovery
When your Colonoscopy is completed, you will be cared for in a recovery area until most of the effects of the medication have worn off. You will be informed about the results of the procedure and any additional information you need to know. Patients are also given instructions regarding how soon they can eat and drink, plus other guidelines for resuming normal activities. Occasionally, minor problems may persist, such as bloating, gas or mild cramping – these symptoms usually disappear within 24 hours. By the time you are ready to go home, you will feel more alert; however, you should plan on resting for the remainder of the day. This means no driving, so you will need to have a family member or friend take you home.
- You may resume your normal diet and activities after an esophageal manometry.
- You may feel a temporary soreness in your throat. Lozenges or gargling with salt water may help.
Board-Certified physicians Dr. Singh, Dr. Rashbaum, Dr. Jae Kim, Dr. Nitin Parikh, Dr. Long B. Nguyen, Dr. Ruth Montalvo and providers Tammi D’Elena, PA-C; and Vanessa T. Dang, MSN, APRN; care for patients in the north Atlanta, GA; area including Johns Creek, GA; Cumming, GA; Lawrenceville, GA; and Alpharetta, GA. The In-House Endoscopy Suite at Digestive Care Physicians, is a certified facility which has achieved the highest level of accreditation by the Association for Ambulatory Health Care (AAAHC). If you suffer from acid reflux or need a colorectal cancer screening, contact us at (770) 227-2222 to schedule an appointment.