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| Esophageal motility study | |
|---|---|
 Diagram of esophageal motility study in 'nutcracker esophagus'. The disorder showsperistalsis with high pressure esophageal contractions exceeding 180 mmHg and contractile waves with a long duration exceeding 6 seconds. | |
| ICD-9-CM | 89.32 |
| OPS-301 code | 1-313 |
| MedlinePlus | 003884 |
Anesophageal motility study (EMS) oresophageal manometry is a test to assessmotor function of theupper esophageal sphincter (UES), esophageal body andlower esophageal sphincter (LES).[1]
An EMS is typically done to evaluate suspected disorders ofmotility orperistalsis of theesophagus. These includeachalasia,diffuse esophageal spasm,nutcracker esophagus andhypertensive lower esophageal sphincter. These disorders typically present withdysphagia, or difficulty swallowing, usually to both solids and liquids even initially. Other patients withspasm disorders may have the test done to diagnosechest pain thought not to be ofcardiac cause.
The test is not useful for anatomical disorders of the esophagus (that is, disorders that distort the anatomy of the esophagus), such aspeptic strictures andesophageal cancer.
A technician places acatheter into the nose and then guides it into the stomach. Once placed in the stomach lining, the catheter is slowly withdrawn, allowing it to detect pressure changes and to record information for later review. The patient will be asked at times to take a deep breath or to take some swallows of water. The degree of discomfort varies among patients. Patients are notsedated because sedatives would alter the functioning of the esophageal muscles. Overall the procedure takes about 45 minutes. After the procedure is complete, patients can usually resume their normal daily activities.
Upper gastrointestinal series and theirfluoroscopic counterparts usex-rays to image the swallowing motions.
Recently,[when?]high resolution manometry (HRM) has been developed that significantly reduces the procedure time (10 minutes versus 45 minutes with conventional manometry) and provides enhanced patient comfort. Newer catheters incorporate concurrent impedance with HRM.