Sore throats happen, but there are some times when a sore throat is a sign that you may need medical care. If it hurts to swallow, you have a hard time swallowing, you have heartburn, or you experience chest pains or regurgitation, you may need to have an esophageal manometry exam. This is a diagnostic test that will assess the function of your esophagus. You can have this exam at Bay Area Gastroenterology Associates in Trinity, FL under the care of our skilled physicians.
What Can I Expect During Esophageal Manometry?
Esophageal manometry is a simple examination that will not require any sedation. This examination is performed as an outpatient examination, so you will be able to take yourself home after the test is complete. There are several steps involved in this exam.
Step One: Numbing
During this treatment, your nostril will be numbed with a topical numbing medication that will ensure you are comfortable during your examination. Although placing a tube in the nose is frequently done in a medical setting, many patients find it more comfortable to use a local numbing agent during this examination.
Step Two: Placing the Tube
Once your nose is prepared for the treatment, a flexible 4mm tube will be inserted into the nostril and passed through the nasal passage down through your esophagus and into your stomach. This portion of the treatment will take about one minute to complete.
After the tube is correctly placed, you will lay down on your left side. The tube will be attached to a machine that is used to record the pressure exerted onto the tube by the muscles in the esophagus; the sensors on the tube are sensitive enough to detect any amount of pressure placed on the tube. By using this measurement, we can then determine the strength or effectiveness of your esophagus muscles, which will allow us to examine the strength of your lower esophageal sphincter.
Step Three: Examination
We will conduct this examination by asking you to take a sip of water, which will cause the muscles in your esophagus to flex and contract. You may be asked to take multiple sips of water so the sensors attached to the tube can gather adequate information. The sensors will track the coordination and strength of the spasms in your esophagus that occur when you swallow. Once we have collected enough data, the tube will be removed and your appointment will be complete.
How Long Does This Treatment Take?
You can expect this examination to take ten to 15 minutes to complete. Most of the time, this outpatient examination is a quick enough appointment that you can easily schedule your exam during any time of the day. After your appointment, the machine connected to the tube will provide data that we can interpret and use as a diagnostic tool for your health concern.
What Happens After the Exam?
After your esophageal manometry is finished, you can go back to your normal daily routine. This includes eating your usual diet, drinking plenty of liquids, and taking any medications as normally prescribed. Some patients like to use lozenges or gargle with warm salt water after the examination to comfort the throat.
Do I Need This Test?
You may need this test if you are experiencing certain symptoms, such as difficulty swallowing or chronic heartburn. Any symptoms associated with your esophagus or chest may be cause for your provider to recommend this test.
Before you can be scheduled for this examination, you will need to talk to your provider about your symptoms. We will ask about your general medical history and whether you have any known diseases associated with this area of the body, such as cardiovascular disease, lung conditions, or allergies to any drugs. You may be an ideal candidate for this examination if you are considering an anti-reflux procedure for the treatment of GERD.
How Can I Prepare for the Test?
We will give you a detailed list of preparation instructions to follow before your exam. First and foremost, you should not drink or eat anything for at least six hours before your test is scheduled so your esophagus and stomach are prepared for the treatment. Depending on when your test is scheduled, you may need to skip breakfast or lunch.
You should not take any calcium channel blockers for at least 24 hours before your treatment. Likewise, you should avoid using any products or supplements that are made with nitrate or nitroglycerine. About 12 hours before your appointment, you should not take any sedatives, such as diazepam or alprazolam. You should also avoid opioid analgesics for at least 48 hours. Please be sure to speak with your provider about all medications and supplements you use regularly before you schedule your appointment.
What Can This Test Diagnose?
Esophageal manometry is a diagnostic exam that is used to diagnose several possible conditions of the esophagus. Conditions such as diffuse esophageal spasms, achalasia, and scleroderma are all possible conditions that may be diagnosed with this treatment.
Diffuse Esophageal Spasms
Diffuse esophageal spasms are a relatively rare condition that is characterized by poor coordination of the esophageal muscles. This condition causes esophageal muscle contractions to be forceful and uncontrollable. These spasms can make it difficult to eat or drink.
Another uncommon condition that can be correctly diagnosed with this test is achalasia, a condition that occurs when food can’t enter the stomach because the lower esophageal sphincter is too tight. The most common symptom associated with this condition is difficulty swallowing, although it may also cause regurgitation.
Causes for Achalasia
Because achalasia is an uncommon condition, research is still trying to determine the cause for the condition. There are a few theories about what causes your esophagus to lose nerve cells or responsiveness. Some researchers believe autoimmune responses and viral infections may be associated with this condition; others think genetics may be a factor that causes this condition.
Anti-reflux surgery is not a treatment for achalasia. However, if this diagnostic test can determine you have achalasia, then you may have several treatment options, including oral or injectable muscle relaxants and pneumatic dilation. You may even have different surgical options.
Scleroderma is a rare disease that progressively causes extreme gastroesophageal reflux. Over time, people who have scleroderma will eventually lose all muscle contractions in the lower esophageal muscles.
Causes for Scleroderma
Researchers know that scleroderma is caused by the overproduction of collagen in the body tissues, including the tissues within your esophagus. But as to why your body tissues produce excessive collagen is unknown. Some evidence suggests that your genes, environmental factors (such as viruses), and certain immune system disorders may trigger scleroderma.
Women are more likely to have scleroderma than men. There is also evidence that this condition is more common for some ethnic groups and that there is a strong genetic component for the condition. Additionally, an estimated 15 to 20% of people diagnosed with scleroderma also have an autoimmune disease, such as rheumatoid arthritis or lupus.
Scleroderma can’t be treated with anti-reflux surgery, but people diagnosed with scleroderma have many treatment options. There are some medications that may help treat the symptoms of excessive collagen production and accumulation, such as antibiotics and antacids to help with digestion and heartburn. Patients may have the option of specific medications to help with diarrhea, bloating, and constipation. If you have additional symptoms, physical therapy can also be helpful for people who have scleroderma.
Is Esophageal Manometry Your Only Option?
There are many other diagnostic tests that can be used to identify conditions of the esophagus. Esophagrams are a common test that can diagnose certain conditions. For an esophagram, you will drink a chalky liquid that will coat and fill the lining in your digestive tract; then an x-ray will be taken to view the silhouette of your esophagus, stomach, and upper intestine.
Schedule Your Exam Today
If you are having troubling symptoms related to difficulty swallowing or chronic heartburn, then you may require a diagnostic test to correctly identify your condition. Please contact us at Bay Area Gastroenterology Associates in Trinity, FL today to schedule your esophageal manometry examination today.