Motility Testing

An esophageal motility study (EMS) or esophageal manometry is a test to assess motor function of the upper esophageal sphincter (UES), esophageal body and lower esophageal sphincter (LES).

The esophagus is a muscular tube that connects the mouth to the stomach, passing through the chest and a small hole in the diaphragm, or breathing muscle, before connecting to the stomach itself. Typically the pressure is relatively snug at the area of the connection between the esophagus and stomach to prevent the stomach contents from refluxing, or going the wrong direction back up into the esophagus. When swallowing occurs, that area of pressure relaxes and the esophagus muscles sequentially squeeze the food down from the mouth and into the stomach.

An EMSis typically done to evaluate suspected disorders of motility or peristalsis of the esophagus. These include achalasia, diffuse esophageal spasm, nutcracker esophagus and hypertensive lower esophageal sphincter. These disorders typically present with dysphagia, or difficulty swallowing, usually to both solids and liquids even initially. Other patients with spasm disorders may have the test done to diagnose chest pain thought not to be of cardiac cause.

To perform this procedure, a technician places a catheter into the nose and guides it into the stomach. Once placed, the catheter is slowly withdrawn, allowing it to detect pressure changes and to record information for later review. The patient will be asked at times to take a deep breath or to take some swallows of water. The degree of discomfort varies among patients. Patients are not sedated because sedatives would alter the functioning of the esophageal muscles and potentially prevent a patient from being able to follow directions properly. Overall the procedure takes about 15-45 minutes. After the procedure is complete, patients can usually resume their normal daily activities.

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