How to prepare for esophageal manometry

 

To prepare for esophageal manometry, do not eat or drink for 6 hours before the test. Only use essential medications the morning of your procedure. Esophageal manometry is used to evaluate difficulty swallowing, non cardiac chest pain and acid reflux. A flexible tube is passed through the nose into the esophagus to measure the pressures across the esophageal sphincters and muscles.

What is esophageal manometry?

Esophageal manometry measures the strength and function of the muscles of the esophagus. The esophagus is an 8-10 inches tube that connects the mouth to the stomach. The muscles of the esophagus through well-coordinated muscular contractions move food and water from the mouth to the stomach.

If these muscular contractions are abnormal, swallowing problem starts. In addition to difficulty swallowing, chest pain, heartburn and regurgitation can occur.

What is the esophageal manometry used for 

  • Investigate the cause of dysphagia. Esophageal motility disorders that can cause dysphagia include achalasia, EGJ outflow obstruction, distal esophageal spasm, Jackhammer esophagus, absent contractility (Scleroderma), and ineffective motility.
  • Examine reason for non cardiac chest pain like diffuse esophageal spasms.
  • Investigate uncontrolled acid reflux symptoms.
  • Requirement before surgery for acid reflux and hiatal hernia.

Who should not do esophageal manometry

  • Patients with known obstruction of the esophagus. An upper endoscopy (EGD) is usually performed before an esophageal manometry to exclude esophageal strictures and obstruction.
  • Those that cannot follow instructions.
  • Patients with recent nose surgery.

What are the risks of esophageal manometry

You may experience some gagging during the procedure especially during the passage of the tube. Once the tube is in place, you can actually breathe and talk normally. If the tube goes down the wrong pipe, you may experience choking feeling. The tube is quickly removed when this happens.

Some people experience nose irritation, nose bleeds and sinus problems after the test. Most of these adverse reactions are temporary.

How long does the esophageal manometry lasts

The test lasts about 30 minutes to 1 hour.

How do I prepare for esophageal manometry

  • You may need to stop certain medications that affect the muscles of the esophagus 24 hours before the test. These are heart and blood pressure medications like amlodipine (Norvasc), nifedipine (Procardia), felodipine (Plendil), diltiazem (Cardizem), verapamil (Calan), hydralazine, isosorbide mononitrate (Imdur), isosorbide dinitrate (Isordil).
  • Also, pro motility medications like erythromycin, azithromycin (Zithromax), metoclopramide (Reglan), domperidone (Motilium). Your doctor will let you know if you have to stop any of these medications.
  • Do not drink or eat anything 6 hours before your procedure. You can take your morning medicines with sips of water.
  • Only use essential medications the morning of your procedure.
  • If you have diabetes mellitus and take insulin, your insulin dose will be adjusted. Do not take short-acting insulin while you’re fasting.

What to expect during the procedure

Your name and the procedure will be confirmed. Tell the nurse or technician if you have a broken nose, recent nose surgery, deviated septum or sinus problems.

You will be asked to sit upright. A numbing lubricant will be applied to your nostril. The technician will pass a flexible plastic tube through the nostril.

The tube is about one-eight inch in diameter. It will pass through your the nose, down the back of your throat into your esophagus and then into your stomach. You will be asked to swallow as it passes down. Sometimes, the tube is passed through the mouth instead of the nose.

Later, with the tube still in the esophagus, you will lie down on your back. You will be asked to swallow multiple times. Please, swallow as commanded. Pressures generated by your esophagus are captured at rest and during swallows.

Once an adequate amount of pressure tracings are captured, the test is completed. The tube will be removed from your nose.

What to expect after the procedure

You do not need a driver to take you home because anesthesia is not used during the test. Resume regular activities after this. You can eat and take your medicines.

Your doctor will notify you of the results.

 

Suggested Reading