What is esophageal manometry?

Gary W. Falk, MD

Manometry is the gold standard for the evaluation of esophageal motor activity and motility. Manometry measures the strength of esophageal contractions and is used to investigate dysphagia and particularly to diagnose achalasia. A new procedure, high-resolution esophageal manometry (HRM), measures pressure events simultaneously along the entire length of the esophagus and is both faster and more accurate than standard manometry. According to David Metz, MD, of the Penn Gastroenterology Division, HRM has greatly improved the ability of gastroenterologists to diagnose and treat patients with achalasia. With the new Chicago Classification, Dr. Metz adds, the test now has prognostic value in achalasia patients because it can identify patients who are likely to do well with surgery. HRM has been further advanced recently by being combined with impedance testing to permit more accurate assessment of bolus transit (movement of swallowed contents) in patients with dysphagia (difficulty swallowing) who may have abnormalities other than achalasia (e.g., ineffective motility, which is commonly associated with GERD).

This test helps determine the strength of the muscles in the esophagus. It is useful in evaluating gastroesophageal reflux and swallowing abnormalities. A small tube is guided into the nostril, then passed into the throat, and finally into the esophagus. The pressure the esophageal muscles produce at rest is then measured.

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