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Esophageal Manometry in Bhubaneswar

Manometry

Esophageal Manometry in Bhubaneswar

Manometry, often known as oesophageal manometry, is a diagnostic procedure that evaluates the movement and pressure of the oesophagus. The oesophagus is a long muscular tube that begins at the hypopharynx and ends at the stomach. It plays a significant role in the digestive process, where the consumed food is passed through the smooth muscles of the oesophagus.

Pre-procedure: During Esophageal Manometry in Bhubaneswar, you will be administered anaesthesia or sedatives if you have any anxiety or nervousness while undergoing the procedure. A catheter with 36 sensors spaced 1 cm apart is inserted through the mouth into your oesophagus until it extends to the stomach. Topical anaesthesia will be applied to mitigate any pain or discomfort.

Procedure: Once the tube is positioned during the procedure, specialists will instruct you to lie on your back to take a baseline reading. You will be given sips of water and solid swallows, like applesauce, later in a sitting position. 

Post-procedure: The tube is slowly withdrawn from the oesophagus, and the results are interpreted and explained. The whole procedure may take 15 to 30 minutes, based on the patient's condition and anatomy. 

 

FAQ's

Specialists consider various indications or factors in manometry, some of which include:

 

  • Exhibition of symptoms, such as difficulty or painful swallowing, gastro-oesophageal reflux, or non-cardiac chest pain

  • Imaging tests that give inconclusive results or are unable to explain your symptoms

  • Done after a Gastrointestinal (GI) swallow or Esophagogastroduodenoscopy (EGD) to rule out any presence of masses or lesions in the oesophagus.

Some conditions that are usually diagnosed with the help of manometry include:

  • Achalasia 

  • Oesophagogastric junction (EGJ) outflow obstruction

  • Distal oesophageal spasms

  • Absence of contractility in the oesophagus 

  • Hypercontractive or jackhammer oesophagus

  • Fragmented peristalsis

  • Weak or infective peristaltic movement

Some key parameters specialists use in interpreting the results of manometry include:

  • Integrated relaxation pressure (IRP), which measures the pressure or how well the lower oesophageal sphincter (LES) responds when food or liquid is passed

  • Distal contractile integral (DCI), which measures the smoothness and effectiveness of peristaltic movement during swallowing

  • Contractile deceleration point (CDP), which measures the speed of muscle contractions in the lower part of the oesophagus

  • Distal latency, which measures the time interval for the food that travels from the upper oesophageal sphincter to CDP.
     

These parameters help to produce colour pressure topography plots, or Clouse plots, which help identify abnormalities in oesophagus functionality, which can indicate motility disorders.

General instructions you can follow to prepare for the manometry test are:

 

  • Refraining from eating or drinking for 6 to 8 hours before the procedure

  • Discuss with your doctor whether to discontinue any medications, such as nitrates, calcium channel blockers, opioids, antacids, proton pump inhibitors, beta-blockers, H2 blockers, caffeine, or sedatives, 24 hours before the procedure. 

  • Informing our specialist of existing conditions, especially those related to heart, lung, or other conditions or co-morbidities

  • Notifying our specialist if you are pregnant or allergic to any medications

Removing any pieces of jewellery or accessories, such as eyeglasses, contact lenses, or dentures

Possible complications or risks that may arise during or after the oesophageal manometry test include:

  • Irregular heartbeat or arrhythmia

  • Accidental inhalation of stomach contents (aspiration)

  • Penetration of oesophageal tube wall (oesophageal perforation)

  • Accidental entry to the larynx or voice box, which causes choking

Significant discomfort in the throat and nose, watery eyes, and a slight nosebleed

Oesophageal manometry tests are generally performed in an outpatient setting and do not require any major recovery instructions or restrictions. Patients can return to normal activities after the procedure. Mild symptoms usually wear off within seven hours, and our specialists may recommend throat lozenges or gargling with salt water if you have a sore throat. Moreover, our specialist may advise against consuming solid foods for a few hours until oesophageal reflux is back to normal.

Some factors that can alter or interfere with the results of the oesophageal manometry test include:

 

  • Medications like nitrates, calcium channel blockers, opioids, antacids, and other medications

  • Previous oesophagal surgeries, such as Gastric Fundoplication, Pneumatic Dilations (PD), Per-oral Oesophageal Myotomy (POEM), or Heller’s Myomectomy

  • A patient diagnosed with large hiatal hernias or peptic strictures

Based on the parameters, treatments include Pharmacological Therapy, Endoscopic Interventions, or Surgery. These may involve the following:

 

  • For older, frail patients or those with minor disorders, medications such as calcium channel blockers or nitrates may provide relief, especially for those who cannot undergo surgery. It can also be helpful for patients with oesophagogastric junction (OGJ) outlet obstruction or a minor peristalsis disorder.

  • For patients who are eligible for surgery but prefer non-surgical options, Endoscopic injections of Botulinum Toxins or Endoscopic Pneumatic Dilation (PD) are recommended. However, Botulinum Injections wear off within months and may require repeated injections. 

  • For patients with failed PD or those diagnosed with achalasia type III, jackhammer oesophagus, distal oesophageal spasms, spastic disorders, or absent peristalsis, and for those who have failed conservative treatments, surgery such as Laparoscopic Heller Myotomy (LHM) or a Peroral Endoscopic Myotomy (POEM) can be employed. 

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