What to Expect During an Esophageal Manometry
As a person with chronic gastrointestinal problems, I have undergone many probing and scoping procedures. Before undergoing my first esophageal manometry, a procedure in which a pressure-sensing probe is inserted through the nose and down the esophagus, I remember that I wished there had been more first-hand accounts that I could read about what to expect from the procedure. This piece will be the first in a series of pieces which will delve into what it is like to undergo different medical procedures that I have personally had to get done. Through this series, I aim to help demystify certain medical procedures for other patients who have to experience them.
I chose the esophageal manometry to be the first procedure that I detail because I remember it as being a particularly difficult procedure for me and because of the nervousness I felt before getting my first one done. It is important to note that every hospital is different, and my experience with the procedure may not match up exactly with the experiences of everyone who has had it done. Here’s what to expect when undergoing an esophageal manometry, based on my own personal experience:
1. The technician will choose which nostril to insert the probe into and may give you a numbing spray.
Before the probe is inserted, the technician will likely ask you if you have any conditions (such as a deviated septum) that may influence the ability of the probe to be inserted. The technician will choose which nostril the probe will be inserted into. A numbing spray may be injected up the nostril before the probe is inserted, depending on the hospital you get the procedure done at. During an esophageal manometry, it is also typical for a patient to wear their own clothes as opposed to being given a hospital gown. Before the probe is inserted, the technician may give you a towel to put over your clothes to prevent them from getting messy during the procedure.
2. The probe will be inserted into the nostril and guided to the top of the throat. The probe will then be guided down the throat and into the esophagus. During this step you will likely have to help by swallowing water.
This step was by far the most uncomfortable for me personally. Having the probe guided to the top of the throat was fairly easy for me to tolerate. The trouble comes when the probe is inserted down the throat and into the esophagus. Because the probe comes in contact with the back of the throat, it is common for the patient’s gag reflex to be triggered. This was the case for me personally, and I found it difficult not to throw up. It is also necessary to swallow the probe during this step to ensure that it goes down the esophagus and not the windpipe. When I had the procedure done, I was given a cup of water to drink to ensure that I swallowed. The good news, however, is that once the probe is fully inserted and stops moving, it is easier to tolerate. Once the probe is in place, it is in and does not need to be adjusted for the rest of the procedure.
3. After the probe is fully inserted, it will be taped into place on your cheek and/or nose and then calibrated. You will also likely be asked to lie down on your back.
Once the probe is in place, the technician will likely tape it to your face to prevent it from moving. Before actual data-collecting trials can be completed, you will be asked not to swallow for a specified amount of time to allow the probe to be calibrated. This step can be harder to complete than it sounds because the feeling of the probe against the back of your throat can make you reflexively want to swallow or gag. I personally found that it helped to hold my breath during this step to prevent myself from swallowing. Do whatever works for you. After the probe is calibrated, you will likely be asked to lie down. This is also harder to do than it sounds because it can be uncomfortable to lie horizontally with the probe in place.
4. During the data-collection stage, you will be instructed to complete about ten swallowing trials. You will usually be required to swallow liquid for these trials, though in some cases foods like applesauce may be used.
During the data-collection trials, the technician will measure out a portion of liquid (usually water) and feed it to you using a syringe. You will be told when to swallow. After swallowing the liquid sample, you will be instructed not to swallow for a specified amount of time so that the trial can run to completion. During the first time I had this procedure done, I was only given water during these swallowing trials. When I underwent the procedure again at a different hospital, I was also given applesauce and a sports drink during some of the trials. Each hospital that administers the procedure has its own methods, so some differences in experience can occur.
5. When all of the trials are completed, the technician will pull the probe out.
Once all of the trials are completed, the end is finally in sight, and the probe will need to be removed. During the two times I had this procedure completed, the technician pulled out the probe quickly using one continuous motion. This step was much easier for me to tolerate than the insertion step was.
While an esophageal manometry can be a difficult procedure to tolerate, it can be important to complete if your doctor has concerns about the muscular functioning of your esophagus. This procedure can be used to diagnose motility disorders like achalasia and esophageal hypomotility. It is also commonly performed before a patient is administered the 24-hour pH probing test used to diagnose acid reflux. If you are scheduled to get the 24-hour pH probing procedure done after the manometry, you can take comfort in knowing that the probe used for the pH test is much thinner and easier to tolerate. Best of luck if you need to get this procedure done soon.
I hope you found this information useful,
[Description of the thumbnail image: The image is a screenshot of the results from my first esophageal manometry. The image depicts the results that the pressure sensing probe collected. Strong pressure is depicted in red, and weak pressure is depicted in green. My results from this procedure showed weak peristalisis.]