Esophageal Manometry & 24-Hour pH Monitoring
These are specialized tests used to evaluate problems related to swallowing, acid reflux, chest pain, and esophageal motility disorders.
Esophageal Manometry
What is Esophageal Manometry?
Esophageal manometry is a test that measures:
- The movement and strength of the esophagus (food pipe)
- Coordination of swallowing muscles
- Function of the lower esophageal sphincter (LES) — the valve between the esophagus and stomach
It helps doctors understand how well the esophagus pushes food into the stomach.
When is it Required?
Doctors may advise this test if a patient has:
- Difficulty swallowing (dysphagia)
- Food getting stuck
- Persistent chest pain not related to the heart
- Chronic acidity or reflux
- Suspected motility disorders
- Regurgitation
- Unexplained cough related to reflux
- Before anti-reflux surgery
Conditions Diagnosed
Manometry helps diagnose:
- Achalasia
- Diffuse esophageal spasm
- Hypercontractile esophagus (Jackhammer esophagus)
- Ineffective esophageal motility
- Scleroderma-related esophageal dysfunction
- LES dysfunction
How is the Procedure Done?
Preparation
Usually:
- Fasting for 6–8 hours
- Certain medicines may need to be stopped temporarily
- Inform the doctor about blood thinners or major illnesses
During the Procedure
- A thin soft tube is inserted through the nose into the esophagus.
- The patient remains awake.
- Small sips of water are given.
- Sensors in the tube record muscle contractions and pressure.
- The test usually takes 20–40 minutes.
Is it Painful?
- Not painful, but can be uncomfortable
- Mild gagging, watering of eyes, or nasal irritation may occur
- Breathing is not affected
Recovery
- Patient can usually go home immediately
- Normal eating can resume unless instructed otherwise
- Mild sore throat or nasal discomfort may occur for a few hours
2. 24-Hour pH Monitoring
What is 24-Hour pH Monitoring?
This test measures:
- How much acid reflux occurs from the stomach into the esophagus
- Frequency and duration of acid exposure
- Correlation between symptoms and reflux episodes
It is considered one of the best tests for diagnosing Gastroesophageal Reflux Disease.
When is it Required?
Doctors may recommend it for:
- Persistent acidity despite medications
- Chronic cough
- Hoarseness of voice
- Recurrent throat irritation
- Suspected silent reflux
- Chest pain due to reflux
- Evaluation before anti-reflux surgery
- Symptoms with normal endoscopy
Types of pH Monitoring
Catheter-based pH Monitoring
- A thin tube is inserted through the nose and left in place for 24 hours.
Wireless pH Monitoring
- A small capsule is attached temporarily to the esophagus during endoscopy.
- It transmits acid readings wirelessly.
How is the Procedure Done?
During the Test
- A thin catheter is passed through the nose into the esophagus.
- It is connected to a portable recorder.
- The patient goes home and continues normal daily activities.
- Meals, symptoms, and sleep timings are recorded in a diary.
- After 24 hours, the catheter is removed.
What Should the Patient Do During Monitoring?
The patient is usually advised to:
- Eat regular meals
- Continue routine activities
-
Record symptoms such as:
- Heartburn
- Cough
- Chest pain
- Regurgitation
- Avoid getting the recorder wet
Is it Painful?
- Mild discomfort in the nose or throat may occur
- Most patients tolerate it well
- Talking and breathing are normal
Recovery
- Immediate return to routine activities
- No admission usually required
- Mild throat irritation may persist
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