Manometry studies

[Buttsy]

Hello,

I am just wondering if anyone as had these studies and what I should expect,I think he said he is requesting the 24 hr test as well.I have looked on line to see what’s involved but was wondering if anyone who as gone through this test could tell me what it’s like?

My Gastroenterologist as requested this test at Salford Royal and a Barium swallow at my local hospital and a Hydrogen breath test.

I am also seeing ENT tomorrow on a 2 week referral as I am having trouble clearing my throat after eating food , it feels like something is stuck on the left side no matter what I eat, I have also been suffering with a sore tongue on that side ,which I think maybe ulcers.

I am very concerned and worried obviously and just praying it’s nothing sinister.

Any insight into Manometry studies from a patient point of view would be helpful, if anyone as any knowledge or advice I would appreciate it

Thank you

[dianekjs]

Yes, I’ve had several esophageal manometry and 24-hr ambulatory pH studies done. I’ve also had the other tests you mentioned. The manometry test isn’t pleasant, but it’s not really painful, it just may make you gag and it’s uncomfortable. If you follow instructions carefully and let the tech coach you through it, you’ll do ok, and the test provides a lot of information. The 24 hr part is mostly just inconvenient, as they’ll send you home with the tube in place for 24 hrs to record acid levels in different parts of the esophagus and your recorded symptoms as they occur. Your doctor should have explained the procedure with you in advance.

For the manometry they will usually use a numbing spray in your nose and then insert a narrow tube or catheter into your nose, down the throat, and then down the esophagus. They’ll have you take swallows of water as they gently insert it so that you are essential swallowing the tube. Once in place they’ll give you water or another liquid to take swallows of while the effectiveness of your swallowing is assessed. There are tiny sensors in the tube and they can see the esophagus on the monitor.

A barium swallow study is easy, they take moving X-rays (fluoroscopy) as you swallow a little liquid and/or solid food. There are a few different methods and variations, but that’s the gist of it. It’s not always necessary to have both that and the manometry study, manometry gives more information about motility. The hydrogen breath tests are so unreliable that most gastroenterologists don’t bother with them anymore. If there are symptoms of SIBO (small intestine bacterial overgrowth) most just try a two week course of Xifaxan and if it resolves symptoms, an empirical diagnosis of SIBO is given. Your sensation of food getting stuck is textbook in scleroderma if that’s what you’re showing symptoms of. The gastroenterologist is the specialist who generally deals with that, and may order an upper endoscopy to evaluate. An ENT doctor has limited usefulness in scleroderma unless they’re trying to rule something specific out. ENTs are also rarely knowledgeable about scleroderma, it’s not really in their wheelhouse. Are you seeing a rheumatologist that has evaluated you for scleroderma?

[Buttsy in reply to dianekjs]

Hi,

Thank you for your detailed response.

Yes I am getting the feeling of food stuck but only on the left side,almost feels like it moves too and tongue soreness on that side too.

My Dr as referred me to ENT as he wants to rule out any throat cancer and he said they will put a scope down my nose and look at throat which he can’t do.

I am seeing a rheumatologist,I haven’t had a firm diagnosis for scleroderma he said probably early limited systemic sclerosis, he as diagnosed fibromyalgia and I have Raynauds. I have an appointment with Professor Denton in February so am hoping for a definite diagnosis then.

[cowhide]

Hi, I have limited systemic sclerosis and swallowing problems and bad reflux. I had manometry studies a couple of years ago. Having read some horrendous reports from patients online I was dreading it, but then relieved it wasn't too bad at all! Nothing like as disturbing as endoscopy and I have had lots of those.

As dianekjs says, follow the instructions you are given carefully, try to relax, this makes it much easier and more comfortable to swallow the tube. I had to do it several times as the technologist thought it wasn't working (it was,,, just my peristalsis so weak it wasn't reading at all until he put it on the very highest setting). During the initial study I asked to sit so I could see the screen, it was really interesting. At Leicester hospitals they give you nbread to swallow, they even put real butter on the bread rather than margarine! (Obviously if you have dietary restrictions you need to tell them).

The 24 hour test was fine, the worst thing for me, as I have bad reflux at night, was that I had to reduce the number of pillows that I use the keep my head elevated, so the reflux was worse that usual. Standard instructions say you have to stop taking any PPIs for a few days beforehand for the 24 hr test but my gastroenterologist over-ruled this, thank goodness. At the end of it, you just whip the tube out yourself and take the capsule back.

Barium swallow I have had a couple of times and is really straightforward, you just swallow some gloopy liquid in various positions.

I also had the glucose hydrogen breath test which is really straightforward, just swallow some really sweet liquid and then blow into a 'breathalyser' when requested, repeated a few times. It confirmed our tentative SIBO diagnosis.

For each of the above procedures, a leaflet was sent through which explained everything, this came with my appointment letter. It also explained any pre-procedure requirements like not eating for a certain time.

Good luck, I am sure you will be fine.

[Buttsy in reply to cowhide]

Hi cowhide,

Thanks for your response and reassurance.

I just want to know now what’s causing my issues, feeling something stuck in my throat , and trouble clearing my throat after eating.I am sure these test will help to find out the issue.I had a Gastroscopy in April this year and did well then with just throat spray, so fingers crossed I should be fine with these test.

Thank you