Oesophageal Manometry and 24 hour pH Studies

What is Oesophageal Manometry?

Oesophageal manometry, also known as oesophageal function or motility testing is a procedure that measures how well the muscles of the food pipe (gullet, or oesophagus) are working. It measures pressure within the food pipe to see if it is too high, too low or in-coordinate.

During the manometry test a thin, flexible tube that contains sensors is passed through the nose, along the back of the throat, down the oesophagus into the stomach.

How does it work?

The oesophagus moves food from the throat down to the stomach with a wave-like motion called peristalsis. Oesophageal manometry will measure how well this movement is performed. It will also allow the doctor to examine the muscular valve (sphincter) connecting the oesophagus to the stomach. The valve should relax to allow food and liquid to enter the stomach and should close to prevent food and liquid moving up from the stomach and back into the oesophagus.

Problem with peristalsis or sphincter function may cause swallowing difficulty, heartburn or chest pain.

What is a 24-hour pH study?

A 24-hourpH study is often done in conjunction with the oesophageal manometry to monitor the levels and changes in acid content in the oesophagus over a 24-hour period, while the patient conducts his or her normal daily activities.  It is used to diagnose gastro-oesophageal reflux disease (GERD – digestive acid passing from the stomach, up into the oesophagus), to determine the effectiveness of medications that are given to prevent acid reflux and to determine if episodes of acidic reflux are causing chest pain.

How does it work?

A smaller tube than that used for oesophageal manometry is passed through the nose into the oesophagus in the same manner as for manometry. This tube is connected to a small recording device that is worn on a belt for the following 24 hours. Food diaries are completed by the patient over the 24 hour period following tube placement to record all food and fluid taken. Diaries should also include information about sleep patterns and symptoms. The tube is removed the next day.

Who would have an oesophageal manometry and/or 24 hour pH study?

The manometry test may be suggested for people who are experiencing the following symptoms;

  • Difficulty swallowing (dysphagia)
  • Pain when swallowing (odynophagia)
  • Heartburn or reflux
  • Chest pain

What are the risks of the procedure?

The Oesophageal manometry and pH study are generally safe procedures and complications are rare. However as with any medical procedure, they do carry a risk of complication.
During the procedures some people may experience;

  • Discomfort or gagging when the tube passes into the throat
  • A slight nosebleed

After the procedures some people may have some mild side effects, including:

  • Sore throat
  • Stuffy nose
  • Minor nosebleed

Extremely rare, but severe complications may include:

  • Irregular heartbeat
  • Stomach contents flowing back into the oesophagus, which can then be taken into the lungs (aspiration)
  • A hole in the oesophagus (perforation)

What are the benefits of testing?

Information obtained from oesophageal manometry and pH studies may help diagnosis of a number of conditions and/or help guide treatment options.

What preparation is required for the testing?

Eating and drinking should be avoided for a certain length of time before the oesophageal manometry and pH study. In addition, some medications may need to be stopped prior to testing. Specific instructions will be provided by the doctor.

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