Esophageal manometry

During esophageal manometry, a thin, pressure-sensitive tube is passed through your nose, down the esophagus, and into your stomach. This test is done in a hospital or outpatient center by a specially trained doctor called a gastroenterologist.

Before the procedure, you receive numbing medicine inside the nose. This helps make the insertion of the tube less uncomfortable.

After the tube is in the stomach, the tube is pulled slowly back into your esophagus. At this time, you are asked to swallow. The pressure of the muscle contractions is measured along several sections of the tube.

While the tube is in place, other studies of your esophagus may be done. The tube is removed after the tests are completed. The test takes about 1 hour.

You should not have anything to eat or drink for 8 hours before the test. If you have the test in the morning, do not eat or drink after midnight.

Tell your health care provider about all medicines you are taking. These include vitamins, herbs, and other over-the-counter medicines and supplements.

You may have a gagging sensation and discomfort when the tube passes through your nose and throat. You may also feel discomfort in your nose and throat during the test.

The esophagus is the tube that carries food from your mouth into the stomach. When you swallow, muscles in your esophagus squeeze (contract) to push food toward the stomach. Valves, or sphincters, inside the esophagus open to let food and liquid through. They then close to prevent food, fluids, and stomach acid from moving backward. The sphincter at the bottom of the esophagus is called the lower esophageal sphincter, or LES.

Esophageal manometry is done to see if the esophagus is contracting and relaxing properly. The test helps diagnose swallowing problems after EGD and imaging tests have not revealed a cause. This test can check the LES to see if it opens and closes properly.

The test may be ordered if you have symptoms of:

• Heartburn or nausea after eating (gastroesophageal reflux disease, or GERD) and a normal EGD
• Problems swallowing (feeling like food is stuck behind the breast bone) and a normal EGD and imaging studies

The LES pressure and muscle contractions are normal when you swallow.

Abnormal results may indicate:

• A problem with the esophagus that affects its ability to move food toward the stomach (achalasia)
• A weak LES, which causes heartburn (GERD)
• Abnormal contractions of the esophagus muscles that do not effectively move food to the stomach (esophageal spasm)

Risks of this test include:

• Slight nosebleed
• Sore throat
• Hole or perforation in the esophagus (this rarely happens)

Esophageal motility studies; Esophageal function studies

Carlson DA, Gyawali CP. Esophageal neuromuscular function and motility disorders. In: Chung RT, Rubin DT, Wilcox CM, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 12th ed. Philadelphia, PA: Elsevier; 2026:chap 46.

DeVault KR. Symptoms of esophageal disease. In: Chung RT, Rubin DT, Wilcox CM, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 12th ed. Philadelphia, PA: Elsevier; 2026:chap 14.

Falk GW, Katzka DA. Diseases of the esophagus. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 124.

Richter JE, Vaezi MF. Gastroesophageal reflux disease. In: Chung RT, Rubin DT, Wilcox CM, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 12th ed. Philadelphia, PA: Elsevier; 2026:chap 48.

Updated by: Todd Eisner, MD, Private practice specializing in Gastroenterology in Boca Raton and Delray Beach, Florida at Gastroenterology Consultants of Boca Raton. Affiliate Assistant Professor, Florida Atlantic University School of Medicine. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.