Esophageal Manometry & Procedure Instructions

Simple and quick to perform, esophageal manometry is an exam that is used to record and evaluate the muscular function of the esophagus. With the information gathered during this exam, a physician can determine the most effective treatment for patients with esophageal muscle disorders. Esophageal manometry is often performed prior to surgical treatment for heartburn/gastroesophageal reflux disease (GERD).

Manometry is the recording of pressures within the esophagus. It can evaluate the contraction amplitude and coordination of the stripping muscle waves in the main portion of the esophagus, as well as in the lower esophageal sphincter (LES).

The esophagus is the tube that carries food and liquid from the throat to the stomach. The wall of the esophagus contains muscle that rhythmically contracts whenever you swallow. This contraction occurs as a sweeping wave (peristalsis) carrying food down the esophagus. It literally strips the food or liquid from the throat to the stomach.

Another important part of the esophagus is the lower esophageal sphincter, or LES. This is a specialized muscle that remains closed most of the time, only opening when swallowed food or liquid is moved down the esophagus or when a person belches or vomits. This muscle protects the lower esophagus from caustic stomach acid and bile. These substances can cause the discomfort of heartburn and, in time, can lead to damage and scarring in the esophagus.

There are several symptoms that originate in the esophagus. These include difficulty swallowing food or liquid, heartburn and chest pain. Additionally, an X-ray (barium swallow or upper GI series) or endoscopy (EGD) may show abnormalities that need to be studied further by manometry. The exam is often done before surgical treatment for heartburn/gastroesophageal reflux disease (GERD). The primary benefit is that a physician has clear documentation of the muscle function of the esophagus.

The procedure takes about one hour, from start to finish. Thin, soft tubing is gently passed through the nose (or occasionally the mouth), while you’re seated in a chair or lying on your side. Upon swallowing, the tip of the tube enters the esophagus, then the technician quickly passes it down to the desired level. Patients may experience some slight gagging that can be easily controlled by following specific instructions. During the exam, the technician will ask you to swallow saliva (called a dry swallow) or water (called a wet swallow). Pressure recordings are taken, then the tubing is withdrawn. Patients can usually resume regular activity, including eating, drinking and taking medicines immediately after the exam.

The manometry tracings are performed by the technician but interpreted by your physician. You will be contacted regarding the results, which will help determine the appropriate next step in diagnosis and treatment.

Nothing really takes the place of manometry. Other techniques that are used to study the esophagus include upper GI X-ray series using swallowed liquid barium; upper endoscopy (EGD) to visualize the inside lining of the esophagus; and a 24-hour probe left in the end of the esophagus to measure acidity as it refluxes from the stomach.

There are minimal risks associated with manometry. Theoretically, esophageal tear/perforation and/or bleeding could occur, but this is extremely rare. Slight gagging is normal during the exam, and a temporary sore throat may be present afterward.

Note: The information in this section is provided as a supplement to information discussed with your healthcare provider. It is not intended to serve as a complete description of a particular topic or substitute for a clinic visit.