Esophageal Manometry (cont.)
What limitations are there to the use of esophageal
manometry?
There are several situations in which esophageal manometry may not
demonstrate the esophageal abnormality that is responsible for a
patient's problem. For example, many patients with GERD have
transient (coming and going infrequently) but prolonged relaxation
(minutes rather than seconds) of the lower sphincter as the cause of
their reflux. Such relaxations may be missed in the short period
during which the manometric study is being conducted. Similarly, if
a patient is having infrequent episodes of chest pain due to
esophageal spasm, for example, every few days or weeks, the spasm may
not be seen during a short manometric study. There have been
attempts to get around these problems by using portable equipment and
prolonged manometry for two or more days; however, prolonged
manometry is not done commonly.
What are the side-effects of esophageal manometry?
Although esophageal manometry is uncomfortable, the procedure is
minimally painful because the nostril through which the tube is
inserted is anesthetized. Once the tube is in place, patients talk
and breathe normally. The side-effects of esophageal manometry are
minor and include mild sore throat, nose-bleed, and, uncommonly,
sinus problems due to irritation and blockage of the ducts leading
from the sinuses and into the nose. Occasionally, during insertion,
the tube may enter the larynx (voice box) and cause choking. When
this happens, the problem usually is recognized immediately, and the
tube is rapidly removed. Care must be used in passing the tube in
patients who are unable to easily swallow on command because without
a swallow to relax the upper esophageal sphincter the tube often
doesn't enter the esophagus but instead enters the larynx.
Are there alternatives to esophageal manometry?
There are no good alternatives to esophageal manometry. However,
special radiological studies using x-rays and swallowed barium (video-
fluoroscopic swallowing study) are available. These studies can
provide complementary information, for example, by identifying
anatomical abnormalities such as narrowing of the esophagus that
also can cause food to stick.
Last Editorial Review: 3/25/2002
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- Gastroesophageal Reflux Disease (GERD, Heartburn) - Learn about gastroesophageal reflux disease (GERD, acid reflux, heartburn) symptoms like heartburn, chest pain, regurgitation, and nausea. Causes, diagnosis, treatment and prevention information is also included.
- Upper GI Series (Barium Swallow) - An upper gastrointestinal GI series, or barium swallow is a test used in assisting in the diagnosis of upper gastrointestinal diseases or conditions such as ulcers, tumors, hiatal hernias, scarring, blockages, and abnormalities of the muscular wall of the GI tract.
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