Esophageal manometry test

Abnormalities in the contractions and strength of the esophagus muscles or in the lower esophagus sphincter can result in chest pain, heartburn and difficulty swallowing.

Esophageal manometry test is used to evaluate the function of the esophagus muscles and the lower esophageal sphincter (LES).

In order to pass food, the esophagus must contract in a sequential manner after swallowing. The top end must contract first, then the middle, and then the bottom. This propels the food downward towards the stomach. At the same time, the LES, located at the end of the esophagus and just above the stomach, must open or relax to allow the food to pass into the stomach.

All of these events are measured during manometry test in terms of pressure. The pressure measurements also measure the length of the LES and can detect a hiatus hernia, if present.

Indications for esophageal manometry test:

1. Gastro-esophageal Reflux Disease (GERD)
   • A short, low-pressure LES is consistent with GERD
   • The presence of a hiatus hernia if present, can be detected
   • Weak esophagus contractions cause GERD
2. Esophageal motility disorders
   • Achalasia: With this condition, the LES fails to relax. As a result, food cannot pass into the stomach and the patient will experience difficulty swallowing.
   • Nutcracker esophagus: This occurs when the esophagus squeezes in sequence, but too vigorously. This can cause chest pain, as well as swallowing difficulty.
   These “primary esophageal motility disorders” can create the same symptoms as GERD. These disorders are treated differently than GERD, so identifying them is very important.
3. Esophageal manometry test is also required prior to anti-reflux surgery. This is to ensure that esophagus pressure problems don’t exist and that the esophagus functions are intact for good surgical results.
4. Accurate placement of the esophagus PH probe for intra-esophageal PH monitoring.

Video of the procedure