1. Esophageal Manometry
Your esophagus is a muscular tube that moves food from your throat to your stomach in a wave-like motion called peristalsis.
Esophageal manometry is a procedure that is used to identify problems with movement and pressure in your esophagus that may lead to symptoms like heartburn and difficulty swallowing. It measures the muscle strength and muscle coordination of your esophagus when you swallow. It also examines the strength of the lower esophageal sphincter (or LES), a muscular valve that connects your esophagus with your stomach. This valve relaxes to allow food and liquid to enter your stomach, and closes to prevent food and liquid from refluxing back up into your esophagus.
During the manometry study, a thin, pressure-sensitive tube is passed through your nose, along the back of the throat, down your esophagus, and into your stomach. This tube is connected to a machine that records the contractions of your esophageal muscles on a graph.
The tube does interfere with your breathing. You will not be sedated for the procedure. A topical anesthetic may be applied to your nose to make placing the tube more comfortable. You may feel some discomfort when the tube is placed, and some patients will experience vomiting and/or coughing; however, most patients tolerate the procedure well.
There are some medications that may affect the results of manometry, such as PPIs and H2 blockers, commonly prescribed for heartburn. You may be asked to discontinue these medications prior to your procedure to ensure accurate test results. Discuss all medications with our office prior to your procedure.
2. 24-hour pH/Impedance testing
24 hour esophageal pH/impedance testing measures the amount of acidic and non-acidic reflux in your esophagus during a 24-hour period of time and assesses whether your symptoms are correlated with this reflux.
During the test, a small catheter is placed through your nose and then swallowed into your esophagus with drinks of water. The other end of the catheter is taped to your cheek, wrapped over your ear, and attached to a small data recorder that you will wear for 24 hours. You will be able to swallow, talk, and breathe without difficulty during the span of the test. You should go about your normal activities to obtain a realistic recording of how much reflux occurs during a typical day for yours.
You will be asked to keep a symptom diary during the test. This diary will be compared to the pH readings obtained from the catheter.
After 24 hours you will have the catheter removed in the office.