High-Resolution Esophageal Manometry is the state of the art way to evaluate the performance of the esophagus. It involves passing a tube through the nose, after using a local anesthetic or numbing medication, and with lubricant.
The tube is swallowed and passed into the stomach. The tube is flexible, soft and about the size of a pencil. It has many sensors on it that create a computerized plot of the esophagus. The patient will swallow water or salt water and occasionally other items to conduct the test. It is done while the patient is awake, and the patient can drive themselves home. It takes about 30 minutes after the tube is placed to do the testing.
This testing is done to identify the causes of difficulty swallowing (dysphagia), chest pain that is not cardiac in nature, and to determine the appropriate surgical and other procedures to manage hiatal hernias. Medications can influence the test results. Upon scheduling this procedure, the patient will be asked to provide a complete list of their medications and the times they are taken. The procedure is typically done in the morning, on an empty stomach. There are few and minimal possible complications from having this test. The nose may be sore briefly, and occasionally the tube cannot be successfully placed.