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What is Oesophageal Manometry?
Oesophageal manometry is a test used at our London clinic to measure the pressure and functioning of the muscles of the oesophagus and lower oesophageal sphincter; in layman’s terms it tests how well the muscles are performing as food and liquids pass from the mouth to the stomach.
You might require oesophageal manometry in London as a diagnostic procedure if you suffer from:
- swallowing difficulties (dysphagia), particularly looking for achalasia, an unusual condition which stops the valve at the bottom of the oesophagus from working properly
- gastro-oesophageal reflux disease (GORD), particularly if surgery is being considered
- non-cardiac chest pain which may be caused by GORD or other unusual oesophageal conditions such as ‘nutcracker oesophagus’ or ‘jackhammer oesophagus’.
We are able to detect a series of abnormalities in this test.
Manometry gives very clear information on whether the swallowing mechanism is working properly. The oesophagus is a muscular tube with valves at the top and bottom ends. We can see each of these components during this test and can determine whether each part is working correctly and whether they are all working together as they should.
It is also possible to detect a hiatus hernia during the test.
Using the latest high resolution solid-state catheters enables us to detect subtle abnormalities which can cause symptoms but which may not be seen using older standard manometry instruments.
The procedure is straightforward
The procedure for oesophageal manometry in London is normally quite short; around 45 minutes from start to finish. Your nostril and throat are numbed with a topical anaesthetic and an ultra-thin flexible tube is passed through the nose, down the back of the throat into the oesophagus and into the stomach.
You will be given small sips of water during the test, so that we can record the contractions of the muscle at rest and during swallows. This allows us to see whether the oesophagus is functioning correctly, and detect whether your swallows are effective.
Risks of the procedure
This procedure is not painful, but some patients do find it slightly uncomfortable. Oesophageal manometry cannot be performed under sedation, as this would affect the performance of the oesophagus. Minor side effects such as discomfort of the throat, nose bleeds (rarely) and sinus problems (very uncommon) may be experienced, but your consultant will be happy to discuss these in full prior to the procedure. If you are taking any regular medication, this should also be discussed prior to the test, and you will be advised if you need to stop taking any such medicine.
If you require oesophageal manometry at our London clinic, you will need to prepare by not eating anything for 6-12 hours beforehand; you can drink water right up to the test.
For more information, or to book a consultation, please contact us on 020 7183 7965.
24 hour pH and impedance studies
Immediately after doing the manometry test, many patients continue to the second test, 24 hour pH and impedance.
This test is very similar to the manometry. An ultra-thin tube (recording catheter) is passed through the nose and into the oesophagus. The outside end of the tube is then attached to a recording device which you wear on your belt.
The recording cathether has multiple sensors along its length. These allow it to detect both acid reflux and non-acid reflux events, whether due to liquid or gas. It is possible to detect whether a burp is due to acid or non-acid reflux from the stomach and also whether the burp is actually due to swallowed air which is trapped in the oesophagus and then brought back up. This is a frequent cause of confusion to patients. Some people are sure that they have acid reflux when, in fact, they are simply air swallowing! It is very important to detect this difference.
Going home after a 24 hour pH study
The test is done as an outpatient procedure. Although there is a tube in place, there is no need to stay in hospital overnight. In fact, we prefer people to go home and behave as normally as possible. The aim of the test is to see how much acid reflux there is on a ‘normal day’. Although people find it uncomfortable to have a tube sticking out of their nose, we encourage them to do whatever they can to bring on attacks of reflux! This gives the most accurate and useful results.
Risks of the Procedure
Like oesophageal manometry, this test is not painful but for some people it is uncomfortable. The good news is that it is very easy to remove the tube at home. We will instruct you on how to do this if needed. Rest assured, the vast majority of people are quite comfortable having this procedure done. Our excellent staff will guide you through what to expect and how to manage during the test.