Motility Tests

ESOPHAGEAL MANOMETRY 

Esophageal manometry is most useful in evaluating patients with dysphagia – a feeling food getting stuck in the esophagus during swallowing, painful swallowing, noncardiac chest pain, and prior to antireflux surgery. It may also be helpful for excluding generalized gastrointestinal (GI) tract disease such as scleroderma.

A small catheter, about 5mm in diameter, which is a pressure transducer, is gently placed into the nose and passed into the stomach after local anesthetic is applied to the nasal passage the throat. The esophageal function will then be evaluated while the patient swallows small amount of water. The patient should fast for 4 to 6 hours prior to the study. No sedation is required.

24-HOUR ESOPHAGEAL PH STUDY AND IMPEDANCE MEASUREMENT

A 24-hour esophageal pH study is the most direct way to measure the frequency of acid reflux. The Impedance measurement detects the direction of the movement of esophageal contents. It is useful to detect acid reflux, non-acid reflux and indicate possible hypersensitivity of the esophagus. It is usually reserved for people whose diagnosis is unclear after endoscopy or a trial of treatment. It is also useful for people who continue to have symptoms despite treatment with acid suppressant.

The test involves inserting a thin tube through the nose and into the esophagus. The tube is left in the esophagus for 24 hours. During this time the patient keeps a diary of symptoms otherwise the patient is encouraged to have normal daily activity. The tube is attached to a small device that measures how often stomach acid is reaching the esophagus. The data are then analyzed to determine the frequency of reflux and the relationship of reflux to symptoms, such as chest pain, asthma, acid reflux, cough, nausea and vomiting, hoarseness, etc.

BRAVO

An alternate method for measuring pH uses a device that is attached to the esophagus and broadcasts pH information to a monitor worn outside of the body. This avoids the need for a tube in the esophagus and nose. The main disadvantage is that an endoscopy procedure is required to place the device (it does not require removal, but simply passes on its own in the stool).

ANORECTAL MANOMETRY

Anorectal manometry is most useful in patients with fecal incontinence and constipation, and may be performed in conjunction with additional tests of anorectal function (such as defecography, pelvic floor electromyography, and anal endosonography). After establishing a diagnosis, anorectal manometry can also be used therapeutically as part of biofeedback retraining

A small catheter, about 5mm in diameter, which consists pressure transducer and rectal balloon, is gently placed into the rectum. The anorectal function is then measured during resting, squeezing the anal sphincter, bearing down, and during rectal balloon distension. No sedation is required.

SMART PILL

SmartPill is an ingestible capsule that measures pressure, pH and temperature as it travels through the gastrointestinal (GI) tract to assess GI motility and transmit wirelessly to a data received. The SmartPill motility monitoring test is performed at a clinic or physician’s office to evaluate motility disorders such as nausea, bloating, heartburn, or an early feeling of fullness when eating. These are often symptoms of a motility disorder, such as gastroparesis, a condition where your stomach does not empty properly, functional non-ulcer dyspepsia. The SmartPill GI Monitoring System measures pH, pressure and temperature throughout the gastrointestinal tract. These physiological measurements are used to determine gastric emptying time (GET), whole gut transit time (WGTT), and combined small-large bowel transit time (SLBTT).

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