Esophageal Motility Study
An esophageal motility study (EMS), also known as esophageal manometry, is a
diagnostic test used to evaluate the motor function of the Upper Esophageal
Sphincter (UES), Esophageal body, and Lower Esophageal Sphincter (LES).
EMS is typically employed to assess suspected disorders affecting the
motility or peristalsis of the esophagus. These conditions may include
achalasia, diffuse esophageal spasm, nutcracker esophagus, and hypertensive
lower esophageal sphincter. Patients with these disorders often experience
dysphagia, or difficulty swallowing, which can affect both solids and
liquids initially.
Additionally, individuals with spasm disorders may undergo EMS to diagnose
chest pain unrelated to cardiac issues. However, EMS is not useful for
diagnosing anatomical disorders of the esophagus, such as peptic strictures
and esophageal cancer, which distort the esophageal anatomy.
During the procedure, a technician inserts a catheter through the nose and
guides it into the stomach. As the catheter is slowly withdrawn, it detects
pressure changes and records information for later analysis. Patients may be
instructed to take deep breaths or swallow water at various intervals during
the procedure.
The level of discomfort experienced during EMS can vary among patients.
Sedation is not administered because it could interfere with the functioning
of the esophageal muscles. Typically, the procedure lasts about 45 minutes,
after which patients can usually resume their normal activities.
In recent years, high-resolution manometry (HRM) has been developed,
significantly reducing procedure time (10 minutes compared to 45 minutes
with conventional manometry) and improving patient comfort. Newer catheters
also incorporate impedance monitoring alongside HRM.
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