Video on additional tests for acid reflux – https://www.youtube.com/watch?v=tIe2-em_O1E
What is Oesophageal manometry?
Oesophagealmanometry is a test used to measure the function of the lower oesophageal sphincter (the valve that prevents reflux of gastric acid into the oesophagus) and the muscles of the oesophagus (see diagram). This test will tell your doctor if your oesophagus is able to move food to your stomach normally. To know why you might be experiencing a problem with your digestive system, it helps to understand the swallowing and digestive processes.
The manometry test is commonly given to people who have:
- Difficulty swallowing
- Pain when swallowing
- Chest pain
The swallowing and digestive processes
When you swallow, food moves down your oesophagus and into your stomach with the assistance of a wave-like motion called peristalsis. Disruptions in this wave-like motion may cause chest pain or problems with swallowing.
In addition, the muscular valve connecting the oesophagus with the stomach, called the oesophageal sphincter, prevents food and acid from backing up out of the stomach into the oesophagus. If this valve does not work properly, food and stomach acids can enter the oesophagus and cause a condition called gastroesophageal reflux disease (GERD).
Manometry will indicate not only how well the oesophagus is able to move food down the oesophagus but also how well the oesophageal sphincter is working to prevent reflux.
Before the test
Tell the physician if you have a lung or heart condition, have any other diseases, or have allergies to any medications
Please follow the instructions below (unless told otherwise by your doctor):
- One day (24 hours) before the test, stop taking calcium channel blockers such as Calan®, Isoptin® (verapamil); Adalat®, Pro-cardia® (nifedipine); and Cardizem®(diltiazem). Also stop taking nitrate and nitroglycerin products such as Isordil® (isosorbide); Nitrobid®, Nitrodisc®, Nitrodur®, Nitrogard®, Transderm-Nitro®, and Tridil®
- Twelve hours before the test, do not take sedatives such as Valium® (diazepam) or Xanax® (alprazolam)
- Do not stop taking any other medication without first talking with your doctor.
Day of test
Eating and drinking
- Do not eat or drink anything 4 to 6 hours before the test.
During the test
- You are not sedated. However, a topical anaesthetic (pain-relieving medication) will be applied to your nose to make the passage of the tube more comfortable.
- A small, flexible tube is passed through your nose, down your oesophagus and into your stomach. This tube is a high-resolution manometry catheter that is about 4 mm in diameter. The tube does not interfere with your breathing. You will be seated while the tube is inserted.
- You may feel some discomfort as the tube is being placed, but it takes only about a minute to place the tube. Most patients quickly adjust to the tube’s presence. Vomiting and coughing are possible when the tube is being placed, but are rare.
- After the tube is inserted, you will be asked to lie on your left side. The end of the tube exiting your nose is connected to a machine that records the pressure exerted on the tube. Sensors at various locations on the tubing sense the strength of the lower oesophageal sphincter and muscles of the oesophagus. During the test, you will be asked to swallow a small amount of water to evaluate how well the sphincter and muscles are working. The sensors also measure the strength and coordination of the contractions in the oesophagus as you swallow.
- The test lasts 10 to 15 minutes. When the test is over, the tube is removed. The gastroenterologist will interpret the recordings that were made during the test.
After the test
- Your physician will notify you when the test results are available or will discuss the results with you at your next scheduled appointment.
- You may resume your normal diet and activities and any medications that were withheld for this test.
- You may feel a temporary soreness in your throat. Lozenges or gargling with salt water may help.
- If you think you may be experiencing any unusual symptoms or side effects, call your doctor.