Antroduodenal Manometry

What is antroduodenal manometry?

Antroduodenal manometry is one of the specialized tests offered at Nationwide Children’s Hospital to understand how a child’s stomach and small intestine are working. It is most often used for children with long-standing nausea, vomiting, belly pain, bloating, feeding problems or trouble gaining weight when other tests have not found a clear cause.
“Antro” refers to the lower part of the stomach (the antrum) and “duodenal” refers to the first part of the small intestine (the duodenum). Antroduodenal manometry measures the strength of muscle contractions in these areas. A very thin, flexible tube called a catheter is placed so that its tiny sensors sit in the stomach and small intestine. These sensors record how strong and how well-coordinated the muscle squeezes are over several hours, both when the child is fasting and after eating.

What does the test help diagnose?

This test helps doctors see how food and liquid move from the stomach into the small intestine. It can show if the muscles in this part of the digestive tract are too weak. The testing can also show if the nerves are out of rhythm. Results can support the diagnosis of conditions such as upper intestinal dysmotility, gastroparesis (slow stomach emptying), rumination syndrome, and intestinal pseudo-obstruction. The results also guide treatment choices, including medicines, nutrition plans and, in rare cases, surgery.

How should we prepare?

Before the test, your child’s care team will review their medical history, current medicines and any problems with anesthesia or breathing. Some medicines that affect gut movement may need to be stopped for a short time. You will get clear instructions about when your child must stop eating and drinking before sedation. In some cases, children may be admitted to the hospital the day of the procedure and stay overnight so the study can be completed safely and comfortably.

What happens during the test?

The catheter is usually placed while your child is asleep under sedation or anesthesia. It may be passed gently through the nose, down the esophagus, through the stomach, and into the small intestine. If your child has a gastrostomy tube (G-tube), the catheter can sometimes be placed through that opening instead. Once the catheter is in position, the recording portion of the test can begin. Over many hours, the catheter is connected to a computer that tracks pressure waves as your child rests, moves, and eats a meal or formula as directed by the care team.

What happens after the test?

When the recording is complete, the catheter is removed. Most children can go back to normal activities and a regular diet soon after, unless the care team recommends otherwise. A pediatric motility specialist reviews the patterns from the test in detail and shares the results with you, usually at a follow-up visit. Together, you will discuss what the findings mean and how they may change your child’s treatment plan. In many cases, the information from antroduodenal manometry helps avoid more invasive procedures and focuses care on what is most likely to help.

Why choose Nationwide Children’s?

Nationwide Children’s Hospital is a leading pediatric neurogastroenterology and motility disorders center, with one of the few dedicated programs in the country offering advanced manometry testing for children. Our team includes pediatric motility specialists, gastroenterologists, surgeons, anesthesiologists, nurses, dietitians and psychologists who understand how complex digestive symptoms affect a child’s daily life. Antroduodenal manometry at Nationwide Children’s uses child-sized equipment, pediatric anesthesia and continuous monitoring to support safety and comfort. Families travel from across the region and around the world for our expertise in evaluating difficult upper gastrointestinal symptoms and building personalized treatment plans that aim to improve nutrition, growth and quality of life.