Esophageal Manometry
A thin tube measures muscle pressures in your esophagus while you swallow water. Diagnoses swallowing disorders (achalasia) and is essential before reflux surgery.
Results
Within a few days; complex cases may take longer for expert interpretation.
This article is educational and does not replace your doctor's advice. Seek urgent care for any red-flag symptoms.
What is it?
A thin pressure-sensing catheter is passed through the nose into the stomach. As you swallow small amounts of water, the catheter records muscle contractions throughout the esophagus and at the lower esophageal sphincter (the valve to the stomach). The pattern reveals normal swallowing, achalasia, esophageal spasm, ineffective motility, or other disorders.
Why is it done?
To diagnose achalasia, esophageal spasm, or other motility disorders. Required before anti-reflux surgery (Nissen fundoplication, LINX) to confirm normal motility. To evaluate non-cardiac chest pain. To investigate persistent dysphagia.
Who needs it?
- Difficulty swallowing of unclear cause after normal endoscopy
- Pre-operative evaluation for anti-reflux surgery
- Suspected achalasia
- Non-cardiac chest pain
Before the procedure
- Fast 6 hours before.
- Stop medications that affect motility (calcium channel blockers, nitrates, prokinetics) for 24-48 hours if your doctor advises.
- Stop PPIs only if your doctor instructs.
- No sedation needed — you must swallow on command.
During the procedure
You sit upright. Local anesthetic is sprayed in your nose. The thin catheter is passed through your nose, down into the stomach. It is positioned and you lie on your back. You take 10-12 small sips of water on cue (the technician asks you to swallow). The catheter records muscle pressures. Whole test takes 30-45 minutes.
After the procedure
You can leave immediately and resume all normal activity. Mild nasal soreness for a few hours. No driving restriction. Results typically available within a few days.
Risks
- Discomfort during catheter insertion (most common)
- Mild nosebleed: rare
- Vasovagal reaction (faintness): rare
- No serious risks
When you get results
Alternatives if you decline
Barium swallow shows anatomy but not muscle function. Endoscopy looks at mucosa. EndoFLIP is a newer technology providing some functional information.
Questions to ask your doctor
Save this list or print it before your appointment — doctors appreciate prepared patients.
- Should I stop my reflux medication before the test?
- What if I cannot tolerate the catheter?
- What does my pattern of pressures mean?
Medically reviewed by: SGA Patient Education Panel · Last reviewed 24/04/2026