Many digestive diseases have similar symptoms such as heartburn, difficult swallowing, and abdominal pain; these symptoms may be misinterpreted leading to inappropriate treatment for the patient. Consequently, it is essential that we have suitable diagnostic equipment to allow more precise diagnosis. At GI and Liver Center of Phyathai 2 Hospital, “Manometry, a test to evaluate the strength and function of your oesophagus, is available to assist the doctor to deliver the right treatment.
What is the test?
Manometry is an effective procedure for determining the contraction of muscles of the esophagus or the lower end of the esophagus (a valve). In some cases, patients visit the doctor with the symptoms of difficulty swallowing and chest pain, but endoscopy cannot identify the cause of the problem. Hence, Manometry is an interesting alternative test since it can clearly show if the esophagus is contracting and relaxing properly.
What is the purpose of the test and How is the test performed?
Manometry can be used to diagnose several esophageal conditions such as achalasia where esophageal muscles become weak, fail to contract properly and the food cannot normally pass down from the oesophagus into your stomach. Manometry is also performed to diagnose chest pain which is not as a result of heart disease. However, chest pain may also be caused by Gastroesophageal reflux disease, or GERD which can be tested by 24 hour pH monitoring. A thin plastic catheter is passed through one nostril, down the back of the throat, and into the esophagus to measure the amount of acid during a 24-hour period. A 24-hourpH study is often done in conjunction with the oesophageal manometry to confirm the diagnosis and identify the real cause of problem.
After measured by Manometry and Achalasia is found, the next step is the treatment by either balloon dilation or laparoscopic Heller myotomy. Balloon dilation is done with the use of a gastroscope, to ensure the balloon being put in the correct position. Following 4-6 weeks of the treatment, a follow-up visit is necessary and if patients still have trouble swallowing, and repeated dilation treatments may be performed with a larger dilator. To illustrate, a 40 year old Arab man visited the hospital with the problem of swallowing, endoscopy was advised and the result showed that the patient experienced GERD. Therefore, the treatment for GERD was given for some period, but the symptom was not improved. Manometry was then suggested for further investigations. Finally, achalasia was detected and the patient was treated by balloon dilation. It appears that when the exact cause of problem is identified, and the suitable treatment is provided, the patient will be recovered and later return to their normal life.
Preparation for the Test
Before an esophageal manometry, the patient cannot eat or drink anything for 6 hours. A small, flexible tube is passed through your nose, down your esophagus, and into your stomach, the tube does not interfere with breathing. The patient will be asked to drink 5 cc water for around 10 times to evaluate how well the muscles of the esophagus are working. The test lasts around half an hour. Generally, manometry is safe procedure, and the side effects of esophageal manometry are minor including mild sore throat or nosebleed.
You may find our specialist at GI Center, Phyathai 2 Hospital
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