Esophageal motility testing is an examination of the esophageal muscles’ function to provide information about their role in transporting food and liquids from the mouth to the stomach. It reveals pressure, movement, coordination of the esophageal muscles, including the function of both the upper and lower esophageal sphincters. It is mostly used in patients with symptoms similar to acid reflux disease for more accurate and targeted diagnosis.
When? Should you undergo esophageal motility testing
- When experiencing symptoms of acid or food reflux from the stomach into the esophagus
- When having difficulty swallowing or feeling food stuck
- When having chest pain and it is found not to be caused by heart disease
What can esophageal motility testing reveal?
The most commonly used esophageal motility test is the evaluation of the lower esophageal sphincter muscle function and detection of esophageal motility disorders, which may present symptoms similar to acid reflux disease. It is used to diagnose esophageal diseases that cause swallowing difficulties or food sticking, such as achalasia, where the lower esophageal sphincter muscle fails to relax, preventing food from passing into the stomach. It also helps diagnose causes of chest pain resulting from abnormal esophageal muscle function, such as diffuse esophageal spasm, which can cause chest pain resembling heart disease.
Procedure for esophageal motility testing
- Fast from food and drink for at least 6 hours before the test
- Apply local anesthetic to numb the nose and throat
- Insert a tube through the nose (or mouth) with a diameter of about 1/8 inch (similar to a baby feeding straw) down to the esophagus or stomach. The patient must swallow to assist during insertion, which may cause coughing or gagging sensations
- The staff may ask for cooperation during the test by swallowing saliva or sipping water periodically to assess the esophageal muscle contractions during swallowing
- During the test, acid may be introduced through the tube to measure esophageal sensitivity
- The test takes about 45 minutes in total, and the tube is removed after completion
- The local anesthetic effect lasts about 1 hour (after the nose and throat become numb), so it is recommended to wait about 1 hour after the test before drinking or eating to prevent choking
- Patients can go home and resume normal activities
Side effects and complications from the test
During tube insertion through the nose (or mouth), patients may cough or feel like vomiting. Deep breathing can help relieve these symptoms. If acid is introduced into the esophagus during the test, patients may feel heartburn or other acid reflux symptoms. After the test, there may be a sore or irritated throat, but this usually improves quickly. Most side effects are mild, such as sore throat, nosebleeds (rare), or possible irritation or blockage of the nasal sinuses, which is very rare.
Patients with swallowing difficulties should be tested with extra caution because the upper esophageal sphincter muscle may not relax properly, causing the tube to enter the airway instead of the esophagus. This can be detected immediately, and the tube will be removed promptly.
Preparation before undergoing esophageal motility testing
- Fast from food and drink after midnight on the day of the test
- Avoid medications that affect gastrointestinal function for at least 7 days before the test, such as antiemetics, antispasmodics, painkillers, sedatives, or tranquilizers
- Certain medications should be continued, such as antihypertensives and heart disease medications, which should be taken as usual with small sips of water on the morning of the test
Note: Please inform and consult your doctor about any medications before the test. Do not adjust your medication on your own.
