Oesophagus amubulatory
“Hospital without walls”
THE OESOPHAGUS
The Oesophagus (or gullet) is a muscular tube, which transports food from the
mouth to the stomach. There is a ring-like muscle (called a sphincter) at the
end of the oesophagus, which prevents stomach contents from moving back
up into the oesophagus. During swallowing, the sphincter relaxes to let food
and drink pass through.
Damage to the oesophagus can occur if this sphincter
 Is weak
 Opens at the wrong time
 Remains open longer than is necessary
Your doctor or nurse may suggest a number of tests, one of which could be
oesophageal manometry and ambulatory 24 hr pH monitoring.
What is Oesophageal Manometry?
This is the measurement of muscle strength within the oesophagus, which can
give your doctor or nurse information about your swallowing reflex, and the
strength and function of the oesophageal sphincter.
What is ambulatory 24-hour pH monitoring?
This is a way of recording the amount and severity of acid reflux into the
oesophagus over 24 hours.
Why do I need these tests?
These tests are performed for a number of reasons:
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You are getting chest pain (non-cardiac)
You have heartburn and not responding to medication
You have chronic heartburn and are being considered for surgery
You have symptoms (such as a chronic hoarse voice) that may be related
to reflux
What preparation is required?
 Certain medications (such as acid suppressants) will need to be stopped for
a number of days – your doctor or nurse will advise you.
 You will not be allowed to eat or drink for 6 hours prior to the test, for
safety reasons.
 You will not be sedated and can therefore resume your normal activities
after the test. You may drive and resume eating and drinking.
How is it performed?
A doctor, nurse or technician will perform the manometry study. They will
first of all take a history of your complaint and then explain the procedure in
detail. Your written consent is required. Please feel free to ask any questions
or ask for further clarification from the health care professional carrying out
the test.
Your nose and throat will be numbed with some nasal drops to minimise any
discomfort and a thin flexible tube will then be passed through the nose into
the stomach. You will be able to breathe, swallow and talk with the tube in
position. During the course of the test, you will need to lie down on a couch
and may be asked to take deep breaths or swallow water or bread. If possible,
please do not talk or swallow unless requested to do so. The pressure changes
in the oesophagus are recorded on a computer and these will be analysed and
reported on afterwards.
For the 24 hour pH test, a different probe will need to be inserted in the same
way as before. It is connected to a recording device (Digitrapper) that you
wear around your waist. You will be asked to press certain buttons on the
Digitrapper in order to record meal times, sleep periods and episodes of chest
pain or heartburn. You will also be asked to keep a written diary regarding
your meals. It is important that you continue about your daily activities as
much as possible, in order to get a realistic picture of your reflux pattern.
You should not get the Digitrapper wet (no showers) as this could interrupt or
terminate the study. You will need to return to the unit the next day to have
the probe removed. The recorded data will then be analysed on a computer.
The whole test will take approximately one hour.
Are there any side effects?
The majority of patients do not experience any side effects. However, some
patients may find that their throat is a little sore for a few hours afterwards. If
you frequently suffer from sinusitis, the procedure may induce a flare-up.
Can I bring someone with me?
You are welcome to bring a relative or friend to support you and who can stay
with you throughout the procedure if you wish.
When will I get the results?
Your doctor will have the results at your next clinic visit. If you do not have an
appointment, one will be made for you.
I am still worried. How can I get more information?
Oesophageal manometry testing is carried out in the Louise Ryan Unit. If you
would like to speak to someone personally, please contact us on the number
below and the staff in the unit will be happy to answer any questions you have.
Louise Ryan GI Diagnostic Unit
10th floor, Royal Free Hospital
Tel/Fax 020 7830 2923