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Esophageal Manometry (or a Motility Study) is a test looking
at the FUNCTION of the esophagus. This is in contrast to the well-regarded upper endoscopy and barium swallow that looks
at the ANATOMY or configuration of the esophagus as it relates to the stomach.
In a motility study, the patient is
asked to “swallow” a flexible tube. This tube is about 3 mm thick and has sensors attached to the tube at different
levels. The patient is then asked to swallow 5 ml of water at a time. The movement or peristalsis of the esophagus is measured
during these swallows. In addition the “squeezing” pressures of the lower esophageal sphincter and at times the
upper esophageal sphincter is measured.
The esophageal and sphincter measurements can be used to provide the clinician
with important information as it relates to the patient’s overall clinical condition. It must be understood that this
test is only a piece of the overall patient’s clinical findings. Esophageal dysfunction can be a primary esophageal
abnormality or a secondary aspect of a more generalized disease.
The test is run in my office. Typically, the patient
should not eat less than 6 hours prior to the test. The patient is placed in a semi-upright position. After the tube is placed
the motility test lasts about 20 minutes. There is some discomfort involved with the test and patients with a severe gag
reflex may have some difficulties. We will help you through this, however. Results can be analyzed and sent to the ordering
physician in a few days.
Indications for motility studies are gastroesophageal reflux disease (especially when there
is a failure of medical therapy) dysphagia (or difficulty swallowing), and atypical chest pain. Of course MECHANICAL causes
of esophageal disease must be ruled out with an upper endoscopy or barium swallow. Contact my office if you have any questions
on this test.
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