ESOPHAGEAL MOTILITY TESTING (ALSO KNOWN AS ESOPHAGEAL MANOMETRY)
An esophageal motility test is typically done to evaluate suspected disorders of motility or peristalsis of the esophagus. These include achlasia, diffuse esophageal spasm, nutcracker esophagus, ineffective peristalsis, and hypertensive lower esophageal sphincter. These disorders typically present with difficulty swallowing, noting a sensation that food and/or liquids seem to get hung up while going down. Other patients with spasm disorders may have the test done to diagnose chest pain thought not to be of cardiac cause. The test is not useful for anatomical disorders of the esophagus (that is, disorders that distort the anatomy of the esophagus), such as narrowing/strictures and esophageal cancer.
An endoscopy nurse places a catheter into the nose and guides it into the stomach. Once placed, the catheter is slowly withdrawn, allowing it to detect pressure changes and to record information for later review. The patient will be asked at various times to take a deep breath or to take some swallows of water. The degree of discomfort varies among patients. Patients are not sedated because sedatives would alter the functioning of the esophageal muscles. Overall the procedure takes about 45 minutes. After the procedure is complete, patients can usually resume their normal daily activities.
Recently, high resolution manometry (HRM) has been developed that somewhat reduces the procedure time and enhances data obtained. This catheter has multiple sensors for more detailed evaluation of esophageal function.