Diagnosing GERD: How An Esophageal Manometry Works
Each method of diagnosing gastroesophageal reflux disease (GERD) has specific benefits. The esophageal manometry procedure allows a physician to directly measure the pressure and function of the lower esophageal sphincter, which many other tests do not. Esophageal manometries can also be used to confirm diagnoses of achalasia, or abnormal swallowing, in addition to GERD.
The test is primarily used to measure the function of the lower esophageal sphincter (LES), but before we look at manometry, let’s take a look at how the LES relates to GERD.
The Lower Esophageal Sphincter & GERD
The LES is directly involved with GERD in that improper functioning of it can cause reflux problems. The LES is the muscular opening in between the esophagus and the stomach, and when it closes it forms a barrier between the two organs. If the sphincter fails to close completely or at the proper time, then acid from the stomach can return back into the esophagus, causing a burning sensation and in some cases even long-term side effects.
What Is A Manometry?
Manometry is defined as the measurement of pressure. In regards to the esophagus, manometry is used to determine how strong the muscles of the esophagus and LES are. Esophageal manometry tests are typically given to patients who have difficulty swallowing, pain when swallowing, heartburn, or chest pain.
When a person swallows, food moves down their esophagus with the assistance of esophageal muscles. These muscles use a wave like motion called peristalsis to usher food through the esophagus and into the stomach. Manometry tests not only measure the strength of a patient’s peristalsis, but also the timing and coordination of the movements. If peristalsis is not in sync with swallowing, then patients can develop esophageal problems.
The manometry test is performed by putting a pressure sensitive tube through the nose, down the back of the esophagus, and into the stomach. The end of this tube is attached to a machine that records the strength, pressure, and timing of the muscles and sphincter. During the test a patient is typically instructed to swallow a small amount of water, so that the machine can analyze how well the LES is working.
What To Expect When You're Expecting (An Esophageal Manometry)
Before the Test: Patients are typically instructed to stop taking any calcium channel blockers 24 hours before the test. These are medications that are used to treat angina and chest pain. Some of these medications include Verapamil, Nifedipine, and Diltiazem. Patients will also be instructed to not take any sedatives such as Valium or Xanax for twelve hours before the test. Patients will be instructed to not eat or drink anything for 4 to 6 hours before the test. All previous conditions (especially lung or heart conditions) and any current medications should be discussed with your doctor before the procedure to ensure your safety.
During the Test: Typically no sedatives are used during esophageal manometry tests, however, a topical anesthetic will be applied to the nose to make sure the patient is not uncomfortable. The tube usually takes less than a minute to place, and although some patients occasionally experience slight discomfort as this point in time, the test itself lasts only 10 to 15 minutes.
After the Test: A gastroenterologist will interpret the results of the manometry, and call you when those results are available. Regular activities and diet can typically be resumed immediately after the test, however, some patients feel some temporary soreness in their throats. You should always follow all of your doctor’s instructions following any procedure, and make sure to tell your doctor if you are experiencing anything abnormal.
Diagnosis
An esophageal manometry is one of several tests used to diagnose Achalasia or GERD, all of which we offer at Tampa Bay Reflux Center. If you’ve been experiencing symptoms like heartburn, chronic reflux, etc. and think you may be suffering from a more serious condition like GERD or Achalasia, schedule an appointment with our reflux specialists.