Esophageal Manometry and Monitoring

Esophageal Motility Study—Manometry and Impedance

The esophagus is an organ that carries food and liquid from the throat to the stomach. the LES (lower esophageal sphincter) muscle lies between the esophagus and stomach and acts as a barrier to prevent the reflux of gastric contents from the stomach into the esophagus. The UES (upper esophageal sphincter) is the muscle that is between the throat and esophagus and acts as a barrier to prevent reflux from the esophagus into the throat. Esophageal Manometry measures the pressure and coordination of the contraction waves in the esophagus; the resting pressure and relaxations of the LES and possibly UES; and the movement of the swallowed material.

Once the procedure begins, a thin tube will be passed through your nose and into your stomach. The tube is then gently pulled back into the esophagus. This tube has pressure sensors in it which register the pressure changes in the esophagus and LES and also the movement of the swallow in various parts of the esophagus.

You will be asked to swallow, and as the esophagus squeezes the tube from the swallowing action, the pressures from that action are transmitted to a computer that records the readings as waveforms. Your doctor will be able to analyze these waveform readings to determine if they are normal or abnormal. The tube will be in place for about 15 to 30 minutes, and the entire procedure takes about an hour to complete.

Esophageal Manometry can determine if there is inadequate, irregular or spastic contraction function in the esophagus. If so, this impaired functioning can result in  GERD, swallowing disorders or pain. Esophageal Manometry is a procedure which can aid in determining the best course of treatment for your condition.

Esophageal pH and Impedance-pH Reflux Monitoring

Esophageal Reflux Monitoring measures the reflux—either acid or non-acid—from the stomach into the esophagus. It is used to diagnose GERD and evaluate the effectiveness of medications that have been prescribed and the treatment needed to prevent acid reflux.

Once the procedure begins, our motility and reflux monitoring specialist will pass an extremely thin tube (1/16th of an inch) through your nose. She will ask you to swallow, and the tube will be guided into your stomach and pulled back to a position just above the LES. The tube has a pH electrode and impedance sensors to register all reflux episodes—acid or non-acid. The other end of the tube, which protrudes from the nose, is connected to a recorder.

You will be sent home with the tube and recorder in place, and each episode of reflux will be recorded for the next 24 hours. You will also be asked to record meals, periods of sleep, and any reflux symptoms. The system probe is very easily removed the next day. The recorder is then attached to a computer, where the information is downloaded and analyzed.