Esophageal motility study

An esophageal motility study (EMS) or esophageal

Esophageal motility study
manometry is a test to assess motor function of the upper
esophageal sphincter (UES), esophageal body and lower
esophageal sphincter (LES).[1]

Indications
An EMS is 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 Diagram of esophageal motility study in
test done to diagnose chest pain thought not to be of 'nutcracker esophagus'. The disorder shows
cardiac cause. peristalsis with high pressure esophageal
contractions exceeding 180 mmHg and
The test is not useful for anatomical disorders of the
contractile waves with a long duration
esophagus (that is, disorders that distort the anatomy of the
esophagus), such as peptic strictures and esophageal exceeding 6 seconds.
cancer. ICD-9-CM 89.32 (http://icd9cm.chrisen
dres.com/index.php?srchtyp
Procedure e=procs&srchtext=89.32&Su
bmit=Search&action=search)
A technician places a catheter into the nose and then OPS- 1-313 (http://www.icd-code.d
guides it into the stomach. Once placed in the stomach 301 code e/ops/code/1-313.html)
lining, the catheter is slowly withdrawn, allowing it to
MedlinePlus 003884
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. Overall the procedure
takes about 45 minutes. After the procedure is complete, patients can usually resume their normal daily
activities.

Other diagnostic tests for swallowing

Upper gastrointestinal series and their fluoroscopic counterparts use x-rays to image the swallowing
motions.

Recent advances
Recently, high resolution manometry (HRM) has been developed that significantly reduces the procedure
time (10 minutes versus 45 minutes with conventional manometry) and provides enhanced patient comfort.
Newer catheters incorporate concurrent impedance with HRM.

See also
Esophageal motility disorder
Nutcracker esophagus
Functional Lumen Imaging Probe
Anorectal manometry

References
1. McNally, Peter R. (1 January 2010). "Chapter 2 - Gastroesophageal Reflux Disease" (https://
www.sciencedirect.com/science/article/pii/B9780323063975000022). GI/Liver Secrets
(Fourth ed.). Mosby. pp. 13–19. ISBN 978-0-323-06397-5. Retrieved 8 January 2022.

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