High Resolution Manometry
The esophagus’ normal function is very important, given that it can propel food using muscular contractions to the stomach no matter the position of the body.
The procedure called esophageal manometry can measure the strength of the rhythmic muscular contractions that take place while swallowing food. It is also able to record the level of coordination of said muscular contractions.
Some motor diseases of the esophagus can alter said muscular contractions. An esophageal manometry is available to determine whether the contractions fall within normal function or they are pathogenic.
There are two types of esophageal manometry:
- Conventional manometry using a perfusion catheter
- High resolution esophageal manometry
The primary advantages of high resolution esophageal manometry over conventional manometry using a perfusion catheter are an increased number of data points and parameters that can be analyzed with many more statistical tools.
The High Resolution Manometry (HRM) is performed with a technologically advanced catheter with 36 pressure points within 2 cm of distance that is used to study the physiological anatomy of the esophageal peristalsis, creating a map of space and time of the motor function of the esophagus. This can help identify segmented motor dysfunctions and transitory relaxation, providing important parameters for diagnosis as well as new criterion for classification of primary motor dysfunction.
The procedure is performed using a thin, flexible tube that is placed through the nose and into the stomach, which remains connected to a device that registers the recorded data from the muscular contractions of the esophagus.
During the procedure, the tube is slowly removed in order to perform different measurements. At various moments during the procedure, it may be necessary for the patient to voluntarily swallow small amounts of water.
What are the indications for a manometry?
The esophageal manometry provides information regarding the movement (motility) of food through the esophagus and toward the stomach. The manometry measures how the circular muscular bands (sphincters) in the upper and lower portion of the esophagus open and close, as well as the pressure, strength, and rhythm of the muscular contractions that transport the food through the length of the esophagus.
If your primary symptom is difficulty swallowing (dysphagia) or painful swallowing, it is likely that the physician will prescribe other tests, such as x-rays or an endoscopy prior to performing a manometry. The initial test will be utilized to rule out the possibility of an obstruction in the esophagus.
Some of the pathologies that are diagnosed with the use of manometry are:
– Diffuse esophageal spasm
– Thoracic pain of non-cardiac origin
– Used to define the need for anti-reflux surgery
– Used to evaluate the functionality of anti-reflux surgery
How do I prepare for an esophageal manometry?
You will be required to fast, avoiding food starting 8 hours prior to the procedure, and will need to pause the use of anti-secretory medication such as:
– Pantoprazol, etc
Avoid antacids such as:
– Aluminum gels
Avoid prokinetic medications such as:
These medications will be paused for at least 7 days prior to the manometry procedure.
What should I expect from the procedure?
The esophageal manometry is an outpatient procedure that is performed without sedation. The majority of the patients tolerate the procedure well. Once over, you can resume normal activities immediately.
The medical report of the test will be ready 2-3 days after the procedure. The results can be part of preoperative evaluation or be used to help identify the cause of symptoms experienced by the patient.
Please plan to discuss the test results with your physician on your following appointment.