Esophageal Manometry Test
Overview
Esophageal manometry measures how well the esophagus moves food toward the stomach. The esophagus is a muscular tube that carries food and liquids from the mouth to the stomach. With each swallow, muscles tighten and relax in a wave-like motion. This test records the strength and coordination of these contractions.
A healthcare provider gently inserts a thin, flexible catheter through the nose and passes it into the esophagus and stomach. The tube contains pressure sensors that detect muscle movements as the individual swallows water. The collected data shows whether the esophagus contracts properly and whether the lower esophageal sphincter (LES) opens and closes at the right times.
Doctors often recommend esophageal manometry for people who have trouble swallowing or symptoms that may suggest problems with muscle function. Some examples of conditions diagnosed with this test include:
| Condition | Description |
|---|---|
| Achalasia | Muscle at the lower end of the esophagus does not relax enough to let food pass. |
| Diffuse esophageal spasm | Muscles contract often, with irregular timing, leading to chest pain or trouble eating. |
| Scleroderma | Weak or absent muscle movements in the lower esophagus, sometimes causing severe reflux. |
Medical teams use manometry results to guide diagnosis and treatment based on each individual’s symptoms.
Reasons for Performing Esophageal Manometry
Doctors order esophageal manometry for several important reasons. They use this test when patients have symptoms suggesting the esophagus may not be working correctly. Some of these symptoms include trouble swallowing, chronic heartburn, unexplained chest pain, or regurgitation of food and liquids. Common conditions explored with this test include:
- Gastroesophageal reflux disease (GERD)
- Achalasia
- Esophageal reflux
- Esophagogastric junction outflow obstruction
- Non-cardiac chest pain
The test checks muscle movement and sphincter function, including the pressure and coordination of contractions along the esophagus. This helps identify weak muscles, narrowed areas, or abnormal wave patterns.
If surgery for GERD is being considered, manometry helps rule out other issues—like achalasia or muscle disorders—that surgery won’t fix. When GERD treatments aren’t working or chest pain isn’t heart-related, the test can guide next steps.
| Symptom/Concern | Why Esophageal Manometry May Be Used |
|---|---|
| Trouble swallowing | Find muscle or motility problems |
| Severe or ongoing heartburn | Check for abnormal reflux or weak muscles |
| Non-cardiac chest pain | Rule out esophageal causes |
| Preparing for anti-reflux surgery | Exclude conditions like achalasia |
| Unexplained regurgitation | Identify food or liquid movement issues |
Things to Watch Out For
Esophageal manometry is usually safe. Some people may have mild issues during or after the test. These can include:
- Gagging as the tube is placed in the throat
- Watery eyes
- Nose or throat irritation
- Sore throat
- Stuffy nose
- A small nosebleed
Most side effects are mild and get better within a few hours.
Getting Ready for the Test
Patients need to have an empty stomach before the procedure, so they must stop eating and drinking as advised by the healthcare provider. They should also tell the healthcare team about any medications they are taking. Sometimes, stopping certain medications is necessary. The test uses pressure sensors on the catheter to measure muscle contractions.
What You Can Expect
What Happens During the Test
Before starting, staff may ask patients to change into a hospital gown. While sitting, they receive a numbing agent—either a spray or gel—on the nose and throat to help reduce discomfort. A healthcare provider then gently inserts a thin, flexible tube (catheter) through the nose and into the esophagus.
This tube may include a water sleeve. Most people breathe normally during this step, though mild discomfort, watery eyes, or a slight gagging sensation are common. Rarely, a minor nosebleed may occur. Once the catheter is in place, patients are asked to either lie down or sit still. A key part of the test involves swallowing small sips of water.
The catheter records pressure, speed, and coordination of esophageal contractions. Staff remind patients to remain calm, breathe slowly, and only swallow when told. The provider may gently shift the tube to collect more data. The test takes about 30 minutes, and staff closely monitor muscle movement throughout.
What to Expect After the Test
After the test, patients can return to their usual daily routines. No recovery time is required, and there are very few restrictions. Eating, drinking, and normal activities can resume right away. If there is mild nose or throat irritation, it typically resolves quickly.
What the Test Shows
The lab typically delivers esophageal manometry results within 1 to 2 days. The findings explain how well the lower esophageal sphincter (LES) functions, including resting pressure and coordination during swallowing. They also show whether esophageal peristalsis is normal or weak. Patients should review the results with their care team.
| Area Checked | What Is Measured |
|---|---|
| LES Pressure | Strength and relaxation of the LES |
| Resting LES Pressure | Pressure while not swallowing |
| Esophageal Peristalsis | Coordination and strength of contractions |
