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Manometry

By

Jonathan Gotfried

, MD, Lewis Katz School of Medicine at Temple University

Reviewed/Revised Mar 2023
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Manometry is measurement of pressure within various parts of the gastrointestinal tract.

Manometry is done by passing a catheter containing solid-state or liquid-filled pressure transducers through the mouth or anus into the lumen of the organ to be studied. It typically is done to evaluate motility disorders in patients in whom structural lesions have been ruled out by other studies. Manometry is used in the esophagus, stomach and duodenum, sphincter of Oddi, and rectum.

Aside from minor discomfort, complications are very rare. Patients must have nothing by mouth (npo) after midnight.

Anorectal Manometry

A barostat balloon may be inflated during the test to evaluate rectal sensation and accommodation. The balloon expulsion test, which is often done together with anorectal manometry, allows for objective assessment of evacuation function.

Barostat

This is a pressure-sensing device that is placed in the gastrointestinal tract to measure accommodation. The device consists of a plastic balloon and an electronic controller that varies the amount of air in the balloon to maintain constant pressure.

This device is used mainly in research studies assessing sensory threshold and altered visceral perception, particularly in functional gastrointestinal disorders.

Esophageal Manometry

Esophageal manometry can be used to diagnose esophageal motility disorders Esophageal Motility Disorders Esophageal motility disorders involve dysfunction of the esophagus that causes symptoms such as dysphagia, heartburn, and chest pain. (See also Overview of Esophageal and Swallowing Disorders... read more such as achalasia Achalasia Achalasia is a neurogenic esophageal motility disorder characterized by impaired esophageal peristalsis and a lack of lower esophageal sphincter relaxation during swallowing. Symptoms are slowly... read more Achalasia , distal spasm Distal Esophageal Spasm Symptomatic distal esophageal spasm (formerly called diffuse esophageal spasm) is part of a spectrum of motility disorders characterized variously by nonpropulsive contractions and hyperdynamic... read more , systemic sclerosis Systemic Sclerosis Systemic sclerosis is a rare chronic disease of unknown cause characterized by diffuse fibrosis and vascular abnormalities in the skin, joints, and internal organs (especially the esophagus... read more Systemic Sclerosis , and lower esophageal sphincter hypotension and hypertension. It also is used to evaluate esophageal function and anatomy such as hiatus hernia Hernias of the Abdominal Wall A hernia of the abdominal wall is a protrusion of the abdominal contents through an acquired or congenital area of weakness or defect in the wall. Many hernias are asymptomatic, but some become... read more Hernias of the Abdominal Wall before certain therapeutic procedures (eg, antireflux surgery, pneumatic dilation for achalasia).

Esophageal manometry references

  • 1. Gyawali CP, Carlson DA, Chen JW, et al: ACG clinical guidelines: Clinical use of esophageal physiologic testing. Am J Gastroenterol 115(9):1412–1428, 2020. doi: 10.14309/ajg.0000000000000734

  • 2. Hirano I, Pandolfino JE, Boeckxstaens GE: Functional lumen imaging probe for the management of esophageal disorders: Expert review from the clinical practice updates committee of the AGA Institute. Clin Gastroenterol Hepatol 15(3):325–334, 2017. doi: 10.1016/j.cgh.2016.10.022

Gastroduodenal Manometry

In this test, transducers are placed in the gastric antrum, duodenum, and proximal jejunum. Pressure is monitored for 5 to 24 hours in both fasting and fed states.

This test is usually used in patients who have symptoms suggestive of dysmotility but have normal gastric emptying study results or who are unresponsive to therapy. It can help determine whether the patient's symptoms or dysmotility result from a muscular disorder (abnormal contraction amplitude but normal pattern) or nerve disorder (irregular contraction pattern but normal amplitude).

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NOTE: This is the Professional Version. CONSUMERS: View Consumer Version
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