If you have difficulty swallowing, it hurts to swallow, you experience regular chest pains, or you have regurgitation or heartburn, you may need an esophageal manometry examination. We perform this diagnostic test at Bay Area Gastroenterology Associates in Trinity, FL to assess the functionality of your esophagus. Today, we’re answering some of the most frequently asked questions about this test, including whether sedation is necessary.
Are You Sedated for Esophageal Manometry?
No, you are not sedated for esophageal manometry. That said, you will not experience any pain during the examination. To ensure the comfort of your nose, a topical numbing medication will be applied to your nasal passage. Once the area is numb, a 4-mm flexible tube will be passed through your nostril, down your esophageal carcinoma, and into your stomach. It only takes approximately one minute to put the tube into place.
What Else Should I Expect During the Examination?
Once the tube is in place, we will ask you to lie on your left side. The end of the tube outside of your nasal passage is attached to a machine that will be used to record the pressure exerted onto the tube. There are many sensors along the tube that are used to identify the amount of pressure being placed on the tube. This allows us to determine how effective your esophagus muscles are.
It also allows us to assess the strength of your lower esophageal sphincter. To determine how effective your esophageal sphincter and esophagus muscles are, we will ask you to take a sip of water. Additionally, the sensors attached to the tube will identify the coordination and strength of the esophageal spasms that occur as you swallow. This entire pain-free test takes a mere 10 to 15 minutes to complete. After that, we will interpret the results provided by the machine.
What Should I Expect After the Test?
Once your esophageal manometry examination is complete, you may resume your usual routine. You may eat and drink whatever you want and resume taking any medications you were asked to stop taking to prepare for the test. That said, you may want to suck on a lozenge or gargle with warm salt water once your examination is complete.
Is This Test Right for Me?
As noted above, this test may be right for you if you are experiencing the symptoms of a condition affecting your esophagus or chest. However, we need to talk to you before determining whether an esophageal manometry exam is appropriate. During this conversation, we need you to advise us on whether you have any known diseases, such as heart or lung conditions, or allergies to any drugs.
We will provide you with a comprehensive set of preparation instructions if we determine this examination is appropriate for you. Note, there is a very good chance this test will be appropriate for you if you are considering an anti-reflux procedure to treat GERD (gastroesophageal reflux disease). It is very important to rule out scleroderma or achalasia before committing to an invasive procedure because it won’t treat achalasia or scleroderma.
How Should I Prepare for My Test?
The most important thing you can do to prepare for your test is to refrain from eating or drinking for six hours before your test is scheduled. For example, you shouldn’t eat or drink anything on the morning of your test after 2 AM if you have an 8 o’clock test scheduled. Similarly, if your test is scheduled for 4:30 PM, you should not eat or drink anything after 10:30 AM.
In the 24 hours prior to your examination, do not take any calcium channel blockers. Additionally, you should not take products containing nitrate and nitroglycerin during this time. A dozen hours prior to your test, do not take such sedatives as diazepam or alprazolam. Do your best to not take opioid analgesics for 48 hours before your test. Let us know during your initial consultation if you do not think this will be possible.
What Conditions Can This Test Diagnose?
There are many conditions that can be diagnosed with this test. Among them are diffuse esophageal spasms, achalasia, and scleroderma.
Diffuse Esophageal Spasms
This rare condition is characterized by poorly coordinated esophageal muscle contractions. These contractions are often extremely forceful and come in uncontrollable waves of repeated spasms.
Achalasia is another uncommon condition that can be diagnosed accurately with this test. It occurs when food can’t enter your stomach because your lower esophageal sphincter muscle will not relax completely. This most commonly leads to difficulty swallowing, but it can also cause regurgitation.
What Causes This Condition
Research is still ongoing regarding what causes achalasia. There are currently several theories on what causes your esophagus to lose nerve cells. For example, autoimmune responses and viral infections have the potential to cause nerve cell loss. Additionally, other types of infections or hereditary factors may lead to this condition.
How This Condition Can Be Treated
To reiterate, anti-reflux surgery cannot treat achalasia. If your esophageal manometry reveals you suffer from achalasia, there is hope. There are numerous effective treatments for this uncommon condition, including oral muscle relaxants, injectable muscle relaxants, and pneumatic dilation. Additionally, there are several surgical options that are effective for the treatment of achalasia.
Scleroderma is a rare progressive disease that causes extreme gastroesophageal reflux. If you suffer from scleroderma, eventually, your lower esophageal muscles will cease to move.
What Causes This Condition
Scleroderma is caused by the overproduction and accumulation of collagen in your body tissues, including your esophagus. Why your tissues start to produce and accumulate excess collagen is unknown. That said, there is evidence to suggest that your genes, environmental factors, and immune system disorders trigger this condition. While anyone can suffer from this condition, women are much more likely to develop this condition than men.
Certain types of this condition are more common for certain ethnic groups and often run in families. Environmental factors that can cause this condition include exposure to certain viruses. Repeated exposure to certain drugs can also increase the risk of scleroderma. Also, it is notable that between 15 and 20% of individuals with scleroderma also suffer from an autoimmune disease, such as lupus, rheumatoid arthritis, or Sjogren’s syndrome.
How This Condition Can Be Treated
Like achalasia, scleroderma cannot be treated with anti-reflux surgery. That said, there are several treatment options. While there is not currently a medication that will stop the overproduction of collagen, several types of medications can help you treat the symptoms of excessive collagen accumulation.
For instance, antibiotics can help food move through your intestines, and antacids can treat heartburn. Furthermore, there are several medications that can treat diarrhea, constipation, and bloating. Additionally, if your scleroderma is causing you other problems, physical therapy can help you maintain your strength, mobility, and independence.
How Else Can Esophageal Conditions Be Diagnosed?
There are several other diagnostic tests that may be run to identify esophageal conditions. For example, esophagrams may be taken to diagnose esophageal conditions. During an esophagram, you will be asked to drink a chalky liquid.
This fluid coats and fills your digestive tract’s inside lining. Then, an X-ray will be taken so we can see a silhouette of your upper intestine, stomach, and esophagus. An esophageal blockage can also be identified if you swallow a barium pill.
Learn More Today
You may benefit significantly from an esophageal manometry examination if you are experiencing symptoms affecting your esophagus or chest. Although you won’t be sedated during this examination, you will not experience any pain or discomfort thanks to topical anesthesia.
To learn more about this valuable diagnostic test, please contact us today at Bay Area Gastroenterology Associates in Trinity, FL to book an appointment. We welcome all of your questions and hope to see you soon.