What is a High-Resolution Manometry test?

August 08 09:19 2022 by admin Print This Article

Overview

High-resolution Manometry test, also called Esophageal Manometry Test is a procedure performed to overcome conditions in the esophagus that make swallowing of food difficult. These conditions can cause repeated chest discomfort, not to mention reduced intake of food. This test measures pressure in the esophagus when the person is resting and when swallowing food. This gives an indication of health of the esophagus. Based on the findings, suitable interventions can be done to fix the problem.

Introduction

The esophagus is an important component of the digestive tract. It is a long thin tube around 8 inches long that connects mouth to the stomach, and helps move the food down for processing. It is made of muscles and is lined by a pink, slimy mucosal layer that lubricates the food movement. Muscles of the esophagus contract and expand in a wave-like motion to push food down, and this movement is called peristalsis.

Two rings of muscles, called sphincters are found, one each, at the beginning and end of this tube to control food passage.

Ailments or Conditions of the Esophagus

There are various conditions that disrupt the process described above. This makes swallowing of food difficult, which is serious, as the food intake is drastically reduced now.

• Heartburn and Gastro Esophageal Reflux Disease (GERD): When the LES does not close completely, some of the stomach contents which are acidic in nature tend to back up or reflux upwards, into the esophagus. This causes heartburn, hoarse voice and cough. When the reflux described above happens frequently and is severe, the condition is called GERD.
• Achalasia: A rare condition, but most common of motility disorder. In this, the Lower Esophageal Sphincter (LES) does not relax properly. As a result, the person experiences difficulty in swallowing.
• Other motility disorders of esophagus excluding Achalasia.

Why is Esophageal Manometry done?

• Diagnose disorders that affect motility of the esophagus (in this rare condition, the peristalsis or muscle contractions of the esophagus are poorly coordinated, forceful and multiple) and Achalasia described above.
• Evaluate all forms of non-mechanical dysphagia which leads to difficulty in swallowing
• As a preparatory test before, and follow-up test after – anti-reflux surgery
• Evaluate chest pain that is not caused by cardiac conditions (chest pain presumed to be of esophageal origin)

Preparing for the procedure

As per the doctor’s instructions, the patient must stop taking current medication for various conditions, in this manner:

• 48 hours before the procedure: All Opioid medication
• 24 hours before: Calcium channel blockers such as diltiazem, nifedipine and verapamil; nitrate and nitroglycerin products such as isosorbide
• 12 hours before: sedatives such as alprazolam and diazepam

How is the procedure done?

The patient must not eat or drink anything for 5-6 hours before the procedure. He/she will not be sedated or given local anesthesia as this can interfere with the normal movements of the esophagus.

 The patient will be taken to the outpatient chamber where the procedure will be done. Numbing gel (a mild sedative) is rubbed into one of the 2 nostrils, in which a thin catheter will be inserted. The other nostril stays free. The catheter is pushed gently through the nostril and down into the esophagus.

The catheter that slides inside has a water-filled sleeve and pressure sensors stuck on it, spaced 1 cm apart. The close spacing of the sensors provides high-resolution data, hence the name. The free-end of the catheter, outside the body is connected to a computer monitor. The computer contains hardware and software that will record the pressure changes in the esophageal muscles as they contract and relax, and display that on the screen.

He/she must breathe slowly, and will then be asked to take a few sips of water. As the water moves through the esophagus, the pressure changes in the esophagus are recorded and displayed.

Based on the findings, the doctor will decide the next step of treatment. The catheter is slowly withdrawn and removed. The whole procedure lasts around 30 minutes.

Recovery

He/she can resume normal activities immediately.

Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai, Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.

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