Digestion occurs through the coordinated movements and contractions of your entire digestive tract, from your esophagus to your anus. These actions are called gastric motility. When digestive muscles become impaired, food can no longer pass normally through your gastrointestinal system. The resulting symptoms can be analyzed with manometry (man-OM-uh-tree) therapy to diagnose the condition.
What is Manometry Therapy?
Manometry therapy is used to determine how well the digestive system’s muscles are functioning. Manometry analyzes several things:
- It explores how effectively the sphincter muscles open and close. Sphincters are ring-shaped muscles that loosen or tighten to regulate substances passing through the digestive tract. For instance, the anal sphincter controls the containment and passage of fecal matter.
- It assesses the pressure of the intestinal tract’s muscle contractions. These contractions carry food through your gastrointestinal system. Nerve and hormone issues can also interfere with proper muscle function.
What are the Types of Gastric Motility Disorders?
Gastric motility disorders include:
Irritable Bowel Syndrome (IBS).
IBS impairs gastric motility by causing it to slow down or go too fast. This can lead to either constipation or diarrhea, as well as pain from irregular contractions.
Esophageal spasms are a rare swallowing disorder characterized by painful contractions of the esophagus – the tube extending from your mouth to your stomach. It can feel as though food is stuck in your throat, and it can cause difficulty swallowing, food backing up into your throat, and sudden, intense chest pain that can mimic a heart attack.
The cause of these spasms is unclear, but it’s theorized that they may be associated with malfunctioning nerves in the muscles that help you swallow.
When you have gastroparesis, your stomach empties too slowly into your intestines. Damaged stomach muscle nerves cause this. It can cause frequent belching, bloating, nausea, heartburn, or vomiting. Sometimes, you’ll feel full after only eating a small amount of food.
A large number of people who have diabetes have gastroparesis. High blood sugar levels associated with diabetes may trigger the condition.
Hirschsprung’s disease is a congenital disorder in which nerve cells are missing from the last section of a child’s large intestine. In some cases, these cells are absent from most or all of the intestine. This disorder causes a stool to travel through the bowel until it comes to the section without nerve cells, where it slows down or stops altogether. Children with Down’s Syndrome are more susceptible to Hirschsprung’s disease.
Scleroderma is a rare autoimmune disease in which the muscles in the lower part of the esophagus harden and tighten. This narrows the esophagus and weakens its muscles. Symptoms of scleroderma include:
- Difficulty swallowing,
- Pain when swallowing.
- Feeling as though food is stuck in your throat.
- Chest pain.
- Severe gastroesophageal reflux disease (GERD). When you have GERD, the acid in the stomach backs up into the esophagus. The stomach acid can erode the esophagus’ lining, triggering more scarring and narrowing.
If you have achalasia, the ring of muscle at the base of your esophagus doesn’t relax when you swallow. This prevents food from traveling smoothly from the food pipe to the stomach. Symptoms of achalasia include heartburn, trouble swallowing, regurgitation, difficulty burping, and chest pain.
What are the Different Types of Manometry Therapy?
The three primary types of manometry therapy are esophageal, rhinomanometry, and anorectal. During these tests, a special manometry catheter, or tube, is used that can check your digestive organs’ strength and motion.
Esophageal manometry therapy is an outpatient procedure used to determine whether the esophagus is relaxing and contracting correctly by analyzing its pressure. A thin, lubricated tube is inserted into your nose and gradually fed down to your stomach during this test. Your nostrils and throat will be numbed to make the procedure more comfortable.
The tube has pressure sensors that relay muscle contractions from various sections of the esophagus to a computer each time you swallow or breathe in and out or take tiny sips of water. These readings show whether the contractions are a typical pressure, pattern, and velocity.
Esophageal manometry therapy takes approximately 10 to 15 minutes and is employed if your symptoms include:
- Chest pain.
- Nausea after eating.
- Pain when swallowing or difficulty swallowing. If these are your primary symptoms, your doctor will schedule X-rays or an upper endoscopy before or instead of esophageal manometry therapy. These tests can identify a constriction or entire blockage of your esophagus. They can also pinpoint inflammation.
Rhinomanometry is a form of manometry that is used to analyze the nasal cavity (the prefix “rhino” means “nose”). It measures the nasal passages’ airflow and pressure when you inhale and exhale. If pressure increases, there is a blockage that air is trying to force itself through.
Before the procedure, you’ll blow your nose, and then a cone will be inserted into both nostrils. One cone will be open, and the other, containing a pressure-sensing tube, will be closed. You’ll be asked to wear a mask that holds the apparatus firmly against your face and breathe in and out. Then the cones will be switched, and measurements are taken to reveal any disproportion or irregularity contributing to weakened airflow.
These measurements can only determine the side of the nose that is obstructed, not the actual obstruction. Acoustic rhinometry is used to analyze an actual blockage.
Acoustic rhinometry employs sound waves that bounce off the nasal cavity to pinpoint obstructions. These reflected waves have a pattern that reveals the structure and size of any abnormalities. During acoustic rhinometry, an acoustic pulse travels to the nose via a tube. This pulse bounces back to a microphone, which transmits the waves to an amplifier and then to a computer that processes the information for analysis. Acoustic rhinometry is an outpatient procedure.
Anorectal manometry therapy is a 30-minute outpatient procedure that measures rectal reflexes, pressure, and sensation. These are important factors for passing a normal stool.
During the procedure, a catheter outfitted with a deflated balloon is introduced into the rectum. The balloon is slowly inflated to expand the area, and you will be instructed to bear down as though you’re pushing out a bowel movement and squeeze as though you’re holding one in. This allows your doctor to make pressure evaluations of each of these actions. Next, the balloon will be filled with water, inserted, and re-inflated. You’ll be seated on a toilet to test whether you can expel it in five minutes or less.
Anorectal manometry is performed in connection with:
- Fecal Incontinence. Fecal incontinence is the inability to control bowel movements, resulting in feces that leak unexpectedly.
- Difficult Childbirth. During childbirth, the anal sphincter may have been damaged, torn, or weakened. The nerves may also be affected. This is more prevalent in women who have a vaginal birth rather than a C-section. Approximately 40 percent of women suffer from this type of delivery-related injury. Giving birth to a large baby can also take its toll on rectal nerves and muscles.
- Chronic Constipation. Decreased muscle contractions can cause chronic constipation in the rectum. It’s characterized by fewer than three bowel movements a week. You may have to strain to go, which can weaken muscles in the rectum and anus. Chronic constipation typically lasts several months.
- Pelvic Floor Dyssynergia. Pelvic floor dyssynergia is a condition that causes your pelvic muscles to tighten the sphincter instead of relaxing and opening it when you’re trying to pass a stool. When your pelvic muscles tighten, it creates painful straining and constipation. This condition may make it challenging for you to pass a bowel movement or know when it’s time for you to have one or finish one.
- Reduced Rectal Sensation. Reduced rectal sensation refers to a reduced or lack of sense that the rectum is full. This feeling is necessary, so you’ll know when you need to go to the toilet or be aware of when to tighten the anal sphincter until you can get to a bathroom.
If you think you might need manometry therapy, contact us today! The team of professionals at GastroMD looks forward to working with you. We are one of the leading gastroenterology practices in the Tampa Bay area. We perform a host of diagnostic procedures using state-of-the-art equipment in a friendly, comfortable, and inviting atmosphere where patient care is always a top priority!