What is Oesophageal Manometry?

When is this test necessary?

Esophageal manometry is indicated for:

• Study the difficulty in swallowing or the feeling that food does not pass from the esophagus to the stomach, that is, study dysphagia.
• Diagnose motility (movement) disorders in patients with swallowing disorders of non-obstructive cause and non-cardiological chest pain.
• Perform preoperative evaluation of patients with gastroesophageal reflux disease, especially in patients with suspected motor disorder.
• Study esophageal involvement in systemic diseases such as scleroderma, neuropathies, myopathies or endocrinopathies.
• Study swallowing disorders after esophagogastric surgery (antireflux surgery, achalasia surgery).
• Study cases in which the gastroscopy test does not show alterations.

The symptoms that the patient usually presents are:

• Difficulty swallowing or sensation of food retention in the esophagus.
• Chest or chest pain.
• Regurgitation. Liquids, food or secretions rise from the stomach into the esophagus or even reach the mouth.
• Esophageal heartburn or burning.

What diseases can it diagnose?

Oesophageal manometry can help diagnose motor diseases of the oesophagus that affect either its mobility (motility) or the functioning of the lower oesophageal sphincter.

The main disease diagnosed by manometry is achalasia, types I, II or III. It can also diagnose diseases that affect oesophageal movement only (peristalsis), without there being any alteration in the relaxation of the oesophageal sphincter; for example:

• Distal oesophageal spasm. This affects those muscles in the oesophagus closer to the stomach than the throat. As a result, rhythmic, coordinated contractions that push liquids and solids towards the stomach become disorganised and painful.
• Hypercontractile oesophagus. This occurs when the muscles contract excessively when swallowing.
• Ineffective oesophageal motility. If the patient has had gastro-oesophageal reflux, the muscles of the oesophagus can contract weakly or in an uncoordinated manner.

How should I prepare for the test?

• You should fast for 6-8 hours.
• You need not be accompanied as it is not performed under sedation.
• The results of previous studies, such as gastroscopy, should be provided.
• Medication for other diseases can be taken, if necessary, but with just a little water.
• If a 24-hour pH test to measure acid reflux is performed alongside the oesophageal manometry, you should stop taking stomach protectors 7-10 days before the test.

How is it performed?

Oesophageal manometry is performed by inserting a thin, flexible tube (catheter) through the nose into the oesophagus until it reaches the stomach. Manometry measures the pressure and movement of the oesophagus but, unlike gastroscopy, does not examine the mucosa lining the oesophagus.

The patient has to stay lying down and relax during the process. The test consists of drinking sips of water at 30-second intervals while lying down; then, drinking more sips of water sitting up, and, occasionally, eating some solid food such as a biscuit.

How long does the test last?

The test lasts 30-40 minutes.

What will I feel during the test? 

Some slight discomfort may be felt when the tube is guided through the nose and throat; however, this can be minimised with a local anaesthetic gel. Nausea or coughing may also occur.

What are the possible complications?

As the test requires nasal intubation, discomfort, bleeding or perforation in the nose, pharynx, larynx or oesophagus may occur, as well as vocal cord injury or bronchial spasm. However, such events are highly infrequent.