Oesophageal manometry
It records the pressure and coordination of oesophageal contractions during swallowing. It is the test of choice when endoscopy is normal but difficulty swallowing persists.
- Diagnosis of achalasia and other oesophageal motility disorders
- Investigation of dysphagia with a normal endoscopy
- Non-cardiac chest pain, once the heart has been excluded
- Assessment before antireflux surgery
- Correct placement of the catheter for pH monitoring
Anorectal manometry
It measures sphincter function and coordination during defecation. It is essential in two situations that are under-investigated and poorly treated:
- Faecal incontinence, to determine which sphincter is failing and to what degree
- Constipation with difficulty evacuating, where the problem is often pelvic floor incoordination that responds to rehabilitation rather than laxatives
How it is done
No sedation is needed. A very thin catheter is passed, through the nose for the oesophageal test or via the anus for the anorectal one, and you perform a series of simple manoeuvres following instructions.
It is uncomfortable but not painful, and takes twenty to thirty minutes. Normal activity can resume immediately afterwards.
Preparation
- Six hours' fasting for oesophageal manometry
- Some drugs affecting motility may need to be stopped; I will tell you at the preceding consultation
- For the anorectal test, an enema a few hours beforehand