What is an esophageal motility study?
An esophageal motility study is a test designed to assess the contractile properties of the esophagus. To perform the procedure, a thin and flexible catheter will be placed into the esophagus through the nose. An esophageal motility study may be performed to help determine the cause of swallowing difficulties, chest pain, or prior to esophageal surgery.
What should I expect the day before the procedure?
You will receive instructions from your doctor regarding the necessary preparation . Most patients will be allowed to eat normally the day before the exam. Patients will be instructed not to take anything by mouth after midnight except for medications. It is very important to follow the instructions given to you by your doctor. There will also be additional instructions regarding your medications. In most cases, your medications will be continued as usual. However, in certain circumstances, especially in patients on blood thinners (i.e. coumadin, warfarin, plavix, aspirin, antiinflammatories) and in diabetics, special instructions will be given.
What happens on the day of the procedure?
You will be asked to arrive at the Endoscopy center 30 minutes before your exam. This is to allow time to fill out paper work and prepare for the exam.
Once in the procedure room, you will be asked to lie on an exam table. One of the nostrils will be numbed with lidocaine. The nurse will then place a thin catheter into the nostril. As the catheter is advanced into the esophagus, you will be asked to swallow to help open up the esophagus. The nurse will initially position the catheter to measure the squeeze of the lower esophageal sphincter. The nurse will then measure the squeeze of the muscles of the body of the esophagus. During this portion of the exam, you will be asked to swallow 10-20 sips of water. Once this is done, you will be finished with the exam and the catheter will be removed. Overall, the exam will take approximately 30-60 minutes.
Because there is no sedation for the exam, you will be allowed to leave the endoscopy unit as soon as you are finished. Most patients are able to eat and drink normally after their discharge from the Endoscopy unit, however, specific instructions regarding activity, eating, and medications will be given to the patient prior to discharge.
When will I get my results?
Because the computer must generate graphs and tables from the data obtained during the exam, results of the test will not be available while you still at the endoscopy unit. The test results will be interpreted by the physician at a later time. You should be contact by the doctor's office within a week with the exam results.
What are the risks of the exam?
Esophageal motility is a very safe procedure. Complications occur in less than 1% of patients. Most complications are not life-threatening, however, if a complication occurs, it may require hospitalization and surgery. Prior to the exam, a consent form will be reviewed with the patient by the nursing staff.
Perforation or puncture of the esophagus is a very uncommon complication, but can occur. This may be recognized at the time of the exam, or it may not be apparent until later in the day. In most cases, a perforation will require a surgery and hospitalization.
It is very important that the patient contact the doctor's office immediately if symptoms arise after the procedure such as worsening abdominal pain, bleeding, or fever.
Like any other test, an esophageal motility study is not perfect. There is a small, accepted risk that abnormalities can be missed at the time of the exam. It is important to continue to follow-up with your doctors as instructed and inform them of any new or persistent symptoms.
What are alternatives to an esophageal motility study?
To an extent, the alternatives to the exam will depend on the reason for needing to undergo the esophageal motility study in the first place. In most cases, the esophageal motility study is the best method to evaluate the muscle function of the esophagus. However, an x-ray called an esophagram, either alone or as part of an upper GI/barium swallow can evaluate the esophagus as well.