Page reviewed by: Mr Nicholas Boyle BM MS FRCS 03/07/20
Manometry provides information about the function of the oesophagus. When we swallow, liquid and solids are normally propelled along the oesophagus into the stomach by coordinated contractions of muscle in its walls. This process is called peristalsis and requires coordination by complex nervous reflexes. In diseases of the oesophagus including GORD (Gastro Oesophageal Reflux Disease) the normal function of the oesophagus can fail. We use a technique called high resolution manometry (HRM) which is the most up to date technology available. It assesses the co-ordination and strength of peristalsis, determines how well the upper (UOS) and lower oesophageal sphincters (LOS) are performing and how well solids and liquids travel through the oesophagus. It can identify disorders related to reflux as well as others that have alternative causes and may require different treatments.
The test takes approximately 20-30 minutes. First, the nostril is numbed with a local anaesthetic spray. A small flexible tube called a catheter is passed through the nostril and down into the oesophagus. The tube has tiny sensors which measure the pressure exerted by the muscles in the wall of the oesophagus. The patient will demonstrate swallowing food and drinking liquid, whilst the tube relays the information to a computer.
The information obtained from this test allows objective evaluation of the swallowing mechanism. For example, some patients with reflux-like symptoms may be found to be experiencing aerophagia (increased swallowing of air) or rumination (forced regurgitation of food). Recognising that these issues are occurring is important for optimised treatment, which is why expert interpretation of manometry findings is so important. Manometry is also essential to identify if you are suitable for anti-reflux surgery and, if so, what type of surgery will be best for you. For instance, your specialist will want to be sure that the strength of peristalsis in the oesophagus is sufficient to open the magnets in a LINX® device so swallowing will be easy following surgery. More information on the LINX® procedure can be found in the ‘LINX® Procedure’ section.