Esophageal Manometry

What is Esophageal Manometry?

Esophageal manometry is a specialized test offered at Nationwide Children’s Hospital to evaluate how a child’s esophagus is working. The esophagus is the tube that carries food and liquid from the mouth to the stomach. This test is often used for children who have trouble swallowing, chest pain that is not from the heart, frequent food sticking in the chest, chronic vomiting, or ongoing reflux-like symptoms that do not improve with treatment.

Esophageal manometry measures how well the muscles and nerves in the esophagus move food toward the stomach. During the test, a very thin, flexible tube called a catheter is passed through the nose and down into the esophagus. The catheter has tiny sensors that measure pressure along the length of the esophagus. These sensors record how strong and how coordinated the muscle squeezes are when your child swallows small sips of water or other liquids.

The test gives a detailed picture of how the esophagus contracts from top to bottom and how the lower esophageal sphincter — the valve between the esophagus and stomach — opens and closes.

What Does This Test Help Diagnose?

Esophageal manometry helps doctors understand why swallowing or feeding may be difficult. It can show:

• Weak or uncoordinated muscle contractions
• Spasms or very strong, painful contractions
• Problems with the lower or the upper esophageal sphincters relaxing or staying closed

These patterns support the diagnosis of esophageal motility disorders, such as achalasia, esophageal spasm, or other nerve and muscle problems of the esophagus. The results can help guide treatment, including medicines, procedures to open tight areas, or other therapies.

How Should we Prepare?

Your child’s care team will give clear instructions before the test. In most cases, your child will need to stop eating and drinking for several hours before the procedure. Some medicines that affect esophageal movement may need to be paused for a short time. The team will review your child’s medical history, allergies and any past problems with procedures. You will have a chance to ask questions and talk through how to help your child feel as calm as possible.

What Happens During the Test?

Esophageal manometry is usually done while your child is awake. Numbing medicine may be placed in the nose to make insertion of the catheter more comfortable. The thin tube is gently passed through one nostril, down the back of the throat, and into the esophagus. Your child will be asked to swallow several times while the catheter is in place. You may be asked to bring some of the child’s favorite foods to test to ingest them during the test. 

The sensors on the catheter measure pressure as the esophagus squeezes. The test usually takes less than an hour. Many children say the tube feels strange or uncomfortable at first, but they often adjust as the test goes on. The team will coach your child through each step and support them throughout the procedure.

What Happens After the Test?

When the test is finished, the catheter is removed. Your child can usually return to normal eating and regular activities soon afterward. A pediatric motility specialist analyzes the results and looks for patterns in the pressure tracings. The findings are reviewed with you at a follow-up visit and used to decide your child’s treatment plan.

Why choose Nationwide Children’s?

Esophageal manometry at Nationwide Children’s is performed in the Neurogastroenterology and Motility Disorders Center, one of the few high-volume pediatric motility centers in the country. Our team includes pediatric motility specialists, gastroenterologists, nurses, dietitians, psychologists and child life specialists who understand how swallowing problems affect nutrition, growth and daily life. We use child-sized equipment, careful numbing and supportive techniques to keep children as comfortable as possible. Families travel from across the region and beyond for our expertise in advanced motility testing and our experience using esophageal manometry results to guide care, with the goal of improving feeding, comfort and quality of life.