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(See also the American Gastroenterological Association's medical position
statement and technical
review on the clinical use of esophageal manometry.) Manometry is measurement of pressure within various parts of the GI tract. It is performed by passing a catheter containing solid-state or liquid-filled pressure transducers through the mouth or anus into the lumen of the organ to be studied. Manometry is typically performed to evaluate motility disorders in patients in whom structural lesions have been ruled out by other studies. Manometry is used in the esophagus, stomach and duodenum, sphincter of Oddi, and rectum. Aside from minor discomfort, complications are very rare. Patients must have nothing by mouth (npo) after midnight.
Esophageal
manometry is used to evaluate patients with dysphagia, heartburn, or chest pain. It measures the pressure in the upper and lower esophageal sphincters, determines the effectiveness and coordination of propulsive movements, and detects abnormal contractions. Manometry is used to diagnose achalasia, diffuse spasm, systemic sclerosis, and lower esophageal sphincter hypotension and hypertension. It is also used to evaluate esophageal function prior to certain therapeutic procedures (eg, antireflux surgery, pneumatic dilation for achalasia).
In gastroduodenal
manometry, transducers are placed in the gastric antrum, duodenum, and proximal jejunum. Pressure is monitored for 5 to 24 h in both fasting and fed states. This test is used mainly in patients who have symptoms suggestive of dysmotility but normal gastric emptying studies.
A barostat is a pressure-sensing device that is placed in the stomach to measure gastric accommodation. The device consists of a plastic balloon and an electronic controller that varies the amount of air in the balloon to maintain constant pressure. This device is mainly used in research studies assessing sensory threshold and altered visceral perception, particularly in functional GI disorders.
Anorectal
manometry evaluates the anorectal sphincter mechanism and rectal sensation in patients with incontinence (and sometimes constipation) by means of a pressure transducer in the anus. It can help diagnose Hirschsprung's disease and provide biofeedback training for fecal incontinence.
Last full review/revision November 2005
Content last modified November 2005
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