Esophageal Motility


Esophageal motility or manometry is used to evaluate patients with symptoms of difficulty swallowing solid and liquid foods (or both), chest pain that is not of cardiac origin, and occasionally heartburn. The test measures the pressures and the pattern of muscle contractions (motility) in your esophagus. The esophagus is a muscular tube that connects your throat to your stomach. With each swallow, the esophagus muscles contract and push food downward into the stomach. At the lower end of the esophagus, a special muscle (sphincter) remains closed except when food or liquid is swallowed or when you belch or vomit. Abnormalities in the contractions and strength of the muscle or in the sphincter at the lower end of the esophagus can result in the above mentioned symptoms.

High resolution manometry (HRM) "figure on the right" is the latest and most sophisticated version of esophageal manometry. It allows for the detection of most complex esophageal motility disorders. Our highly trained doctors usually perform the test at our Joy McCann Culverhouse Center for Swallowing Disorders (CSD) at the Morsani clinic building but occasionally at Tampa General Hospital.

The test is done on an empty stomach for 6 hours before the test to allow for the best and safest examination. Since many medications can affect esophageal pressure and the natural muscle contractions required for swallowing, be sure to discuss with your healthcare professional each medication you are taking. Your doctor may ask that you temporarily stop taking one or more medications before your test.

A numbing medication is applied to the inside of your nostril(s). Then a thin, flexible, lubricated tube (manometry catheter) "figure on the left" will be passed through your nose and advanced into your stomach while you swallow sips of water. Mild, brief gagging may occur while the tube is passed through the throat. When the tube is in position, you will be sitting upright while the tube is connected to a computer. You will be instructed to breathe slowly and smoothly, remain as quiet as possible and avoid swallowing unless instructed to do so. You will be given a cup of liquid to have ten wet swallows and if satisfactory results are obtained, the manometry catheter is removed and the test is finished. Since you have to make intentional swallows, sedation cannot be administered 6 hours before or during testing. You can continue your daily meals, medications, and activity for the remainder of the day unless you were instructed otherwise. No adult driver is needed to take you home. The test will take approximately 30 minutes to complete and the results will be sent to your doctor’s office in 5-7 days.

While serious side effects of this procedure are extremely rare, it is possible that you could experience irregular heartbeats, aspiration (when stomach contents flow back into the esophagus and are breathed into the lung), or perforation (a hole in the esophagus). During insertion, the tube may be misdirected into the windpipe before being repositioned. Precautions are taken to prevent such risks, and your physician believes the risks are outweighed by the benefits of this test. In some situations, correct placement of the tube may require passage through the mouth or passing the tube using endoscopy (a procedure that uses a thin, flexible lighted tube). Your physician will determine the best approach.