Esophageal manometry measures the strength and coordination of the muscle contractions that move food down the food pipe, along with the function of the valves at either end. At Delhi Gastro Care, Fortis Escorts Hospital, Okhla Road, South Delhi, this test helps identify the cause of swallowing difficulty and guides decisions on treatments such as POEM or anti-reflux surgery.
What is Esophageal Manometry
Esophageal manometry is a diagnostic test that measures pressure and muscle activity along the length of the esophagus as you swallow. A thin, flexible catheter fitted with pressure sensors records how well the esophageal muscles contract and relax, and whether the upper and lower esophageal sphincters open and close normally. Most centres, including this one, use high-resolution manometry (HRM), which records pressure at multiple points simultaneously for a more detailed picture than older systems.
When Manometry is Recommended
Doctors recommend esophageal manometry when there is a specific reason to check how the esophagus is functioning, rather than just how it looks on endoscopy.
Unexplained difficulty swallowing (dysphagia) with a normal-looking endoscopy
Suspected achalasia or other esophageal motility disorders
Non-cardiac chest pain once heart-related causes have been ruled out
Pre-operative assessment before anti-reflux (fundoplication) surgery
Assessment before POEM, to confirm the diagnosis and plan the extent of myotomy
Follow-up after treatment for achalasia or other motility disorders
How the Test is Performed
Esophageal manometry does not require sedation and is usually completed as an outpatient procedure.
- A thin catheter is passed gently through the nose and down into the esophagus and stomach
- The patient is asked to swallow small sips of water at intervals while lying down or sitting comfortably
- Pressure sensors on the catheter record the strength and coordination of each swallow
- The doctor reviews the pressure patterns to assess muscle contraction and sphincter function
- The test typically takes around 15 to 30 minutes from start to finish
Preparing For The Test
- Fasting for a few hours before the test, usually avoiding food and liquids for around 4 to 6 hours
- Informing the doctor about any medications being taken, since some can affect esophageal muscle activity and may need to be paused before the test
- Sharing any nasal or sinus conditions that could make catheter placement more difficult
- No sedation is used, so patients can drive themselves home and resume normal activity immediately after
What to Expect After the Test
There is no recovery time needed after esophageal manometry. Mild throat or nasal discomfort during catheter placement is common but settles quickly once the catheter is removed. The pressure readings are reviewed by the gastroenterologist, and the results are usually discussed at a follow-up consultation, where they are considered alongside endoscopy findings and symptoms to plan the next step in treatment.
Why Choose Delhi Gastro Care
Delhi Gastro Care is led by Dr. (Brig) Pankaj Puri, Director of Gastroenterology & Hepatology at Fortis Escorts Liver and Digestive Diseases Institute, Okhla, New Delhi, whose clinical focus includes advanced therapeutic endoscopy for esophageal disorders. Manometry findings at this centre are reviewed alongside related facilities such as upper GI endoscopy and POEM, so a swallowing problem can be diagnosed and treated within the same team.
Frequently Asked Questions
It is used to measure how well the esophagus muscles contract and how the sphincters at either end function, helping diagnose the cause of swallowing difficulty, suspected achalasia, or unexplained chest pain.
The test is not painful, though passing the catheter through the nose can cause brief discomfort or a gagging sensation. No sedation is required, and most patients tolerate it well.
The test usually takes around 15 to 30 minutes, including the time needed to position the catheter and complete the series of swallows.
Yes, manometry is commonly done before POEM or anti-reflux surgery to confirm the underlying motility problem and help the surgical or endoscopic team plan the right extent and location of treatment.