Esophageal manometry - Medical experts

Endoscopy of the gastrointestinal tract is performed as a first measure to rule out organic causes. Oesophageal manometry is usually only carried out when endoscopy or other imaging procedures have not been able to provide precise information about disorders in the oesophagus.

When is oesophageal manometry performed?

Oesophageal manometry is used to examine the swallowing process in the area of the upper and lower oesophageal sphincter (oesophageal sphincter) and the actual oesophagus (tubular oesophagus). Indications for esophageal manometry are

• Swallowing disorders in the case of an unremarkable gastroscopy,
• clarification of chest pain that is not caused by another disease such as heart disease,
• before planned surgery for reflux disease,
• unclear globus sensation or
• suspected involvement in the context of another disease, e.g. rheumatism.

The pressure caused by the act of swallowing in the oesophagus is transferred to the pressure measurement points. The pressure changes are stored by a device (PC) and displayed as a computer graphic.

Procedure for oesophageal manometry

Oesophageal manometry is a painless, albeit sometimes somewhat unpleasant, examination in which a thin catheter is inserted through the nose and oesophagus into the stomach. The examination is carried out in a sitting position. After a familiarization phase, the patient is given water to drink in short intervals. The duration of the examination is 15 to 20 minutes.

Side effects are rarely observed. Injuries to the nasopharynx, oesophagus and stomach may occur.

Two possible procedures

In principle, two methods are available. Conventional perfusion manometry and manometry using electronic pressure transducers. In "high-resolution manometry", catheters with 36 measuring points are now available so that the probe can remain static in the oesophagus during the swallowing act and a pull-through procedure is no longer necessary. The methods differ mainly in their technical design. Valid results are achieved with all procedures.

Results of oesophageal manometry

Possible diagnoses are esophageal diseases such as esophageal achalasia, diffuse esophageal spasm, hypertensive esophagus (nutcracker esophagus) and secondary motility disorders in the context of other diseases. It is important to exclude these diseases before performing anti-reflux surgery for reflux disease.

Result of high-resolution manometry (normal findings)

In addition, the indication for an X-ray examination of the esophagus with contrast medium and, if necessary, pH-metry can be discussed with the patient.