Manometry: Treatment, Effects & Risks

A manometry is a medical examination method used to clarify various complaints in the digestive tract. Through the insertion of a plastic catheter, the pressure conditions in the respective organ can be determined and thus any functional disorders of the muscles can be concluded. The examination can take place on an outpatient basis and is comparatively low-risk if performed correctly.

What is manometry?

In a manometry, a thin catheter is inserted into the esophagus or rectum, for example. This examination method is used to clarify various complaints in the digestive tract. Manometry is a gastroenterological examination method used by physicians. A thin catheter is inserted into the esophagus or rectum. The catheter has several capillaries that are able to measure the pressure in the organ concerned. In this way, functional disorders of the musculature can be detected. The examination is used for symptoms such as motility disorders of the stomach and intestines, swallowing difficulties, fecal incontinence and constipation, and reflux disease. Due to the diversity of symptoms and organs, physicians distinguish three types of manometry: rectal manometry for the examination of the sphincter and rectum, small bowel manometry and esophageal manometry for the examination of the esophagus. The examination takes between 15 and 30 minutes, depending on the exact area of application. In the case of small bowel manometry, a recording device that remains in the body for 24 hours can also be inserted to obtain a particularly precise insight into the function of the organ. If there are no unforeseen complications, manometry is performed on an outpatient basis, allowing the patient to leave the hospital afterwards.

Function, effect, and goals

When a patient visits his or her physician with chronic constipation, persistent heartburn, difficulty swallowing or general digestive problems, the physician will order appropriate tests in addition to a detailed discussion. In most cases, an endoscopy of the esophagus, stomach or intestines is initially performed. This can detect or rule out pathological changes in the organs. An X-ray examination with additional administration of a contrast medium can also provide information. If these measures do not provide clear results, there may be a disturbance of the muscle reflex or the pressure conditions. This can lead, for example, to gastric acid rising into the esophagus or to problems with bowel movements. Manometry is used as an additional gastroenterological examination to confirm or reject this diagnosis. Esophageal manometry is performed in a sitting position. The patient must have been fasting for about four hours beforehand. The catheter is inserted through the nose into the esophagus. Once the probe has been placed in position, he lies down and the measurement of the resting pressure in the esophagus can take place. The examination takes about 30 minutes. If the rectum or sphincter is to be examined, the patient is given an enema about half an hour beforehand. Then the catheter is inserted into the rectum and the pressure is measured. The procedure is completed after just under 15 minutes. Manometry of the small intestine is the most complex examination. The patient must fast for 15 hours beforehand. The probe is inserted through the nose down into the small intestine. Beforehand, it may be necessary to perform a gastroscopy. Measurements are taken repeatedly over a period of four hours. The patient is then given a test meal, after which measurements are taken again. During the examination, the attending physician looks at the monitor, on which the pressure conditions are displayed in the form of curves. From this, he can read off disturbances and impairments. Continuous measurement over a period of 24 hours is also possible if required. After manometry, the patient remains in the clinic for a short observation period and can then be discharged home. If a disturbance of the muscle reflexes or the pressure in the organ in question has been detected, the physician can make a final diagnosis and begin appropriate therapy. How this turns out depends on the organ affected and the type of disorder. For example, if reflux disease is present, it can be remedied by a change in lifestyle or, in severe cases, surgically.In the case of sphincter weakness, treatment methods range from medication to pelvic floor exercises to surgery as well. The situation is similar with constipation (a chronic blockage).

Risks, side effects and dangers

Manometry is a comparatively low-risk examination method that can be performed regardless of the patient’s other health conditions. Since no anesthesia is required, it places little stress on the organism. The examination is performed professionally and by trained personnel. For this reason, most patients do not experience any unpleasant side effects or consequences. Under certain circumstances, esophageal manometry or small bowel manometry may cause temporary irritation of the pharynx and a slight retching sensation, but this quickly subsides when the manometry is completed. Increased salivation may cause the patient to choke; however, this can be prevented by quiet breathing and aspiration of saliva if necessary. Examination of the rectum may cause foreign body irritation and a temporary feeling of pressure. On the other hand, proper insertion and removal of the probe does not cause pain. During the examination, the patient should make sure to sit or lie still and follow the instructions of the medical staff. Careless movements can cause the probe to slip off, which can result in injuries to the organ walls. A comprehensive discussion between the physician and patient in advance and a detailed explanation of manometry can prevent possible risks.