Esophageal Manometry and Impedence Testing
To evaluate for problems with esophageal motility, manometry with impedance is the gold standard test. The pressure sensors used on the manometry catheter give us information about the strength and coordination of esophageal contractions in four different locations. The impedance sensors detect ionic changes in liquids or semi-solids as they pass through the esophagus into the stomach. These impedance measurements tell us if material is passing too slowly through the esophagus, which can contribute to a feeling of fullness or a sensation of a swallowing problem.
The manometry/impedance test takes about 20-30 minutes to complete. This is the first step in performing a pH test, to help us locate the level of your upper esophageal sphincter and lower esophageal sphincter. You will be in a reclined position in a quiet room. Your nose will be sprayed with a numbing medicine to help make the test more comfortable. The catheter, which measure 4 mm in diameter, is then placed through your nose and into your esophagus. You will be asked to swallow approximately 25 times so that the pressure and impedance measures can be generated.
At times, we need to know more detail about the pressures in the upper esophageal sphincter and throat, particularly in the setting of globus (lump in throat). In this case, a smaller 2.1 mm catheter can be used to obtain detailed pressure measurements in the upper esophageal sphincter and two sites in the throat.
High Resolution Manometry with Impedance will be offered soon at the Center for Voice and Swallowing Disorders. This system measures 32 different pressure sites in the esophagus and throat, providing greater detail and insight into the motility problem.
This manometry tracing shows esophageal spasm, which can cause dysphagia and/or chest pain.