Overview
A thin pressure-sensing catheter is passed through the nose into the stomach. As you swallow small amounts of water, the catheter records muscle contractions throughout the esophagus and at the lower esophageal sphincter (the valve to the stomach). The pattern reveals normal swallowing, achalasia, esophageal spasm, ineffective motility, or other disorders.
Who needs it
Difficulty swallowing of unclear cause after normal endoscopy
Pre-operative evaluation for anti-reflux surgery
Suspected achalasia
Non-cardiac chest pain
Risks
Discomfort during catheter insertion (most common)
Mild nosebleed: rare
Vasovagal reaction (faintness): rare
No serious risks
Before the procedure
Fast 6 hours before.
Stop medications that affect motility (calcium channel blockers, nitrates, prokinetics) for 24-48 hours if your doctor advises.
Stop PPIs only if your doctor instructs.
No sedation needed — you must swallow on command.
When to See a Doctor
Call your doctor or go to emergency if after the procedure you have severe or worsening abdominal pain, fever, repeated vomiting, heavy bleeding, black stools or fainting.
Why it is done
To diagnose achalasia, esophageal spasm, or other motility disorders. Required before anti-reflux surgery (Nissen fundoplication, LINX) to confirm normal motility. To evaluate non-cardiac chest pain. To investigate persistent dysphagia.
During the procedure
You sit upright. Local anesthetic is sprayed in your nose. The thin catheter is passed through your nose, down into the stomach. It is positioned and you lie on your back. You take 10-12 small sips of water on cue (the technician asks you to swallow). The catheter records muscle pressures. Whole test takes 30-45 minutes.
After the procedure
You can leave immediately and resume all normal activity. Mild nasal soreness for a few hours. No driving restriction. Results typically available within a few days.
When you get the results
Within a few days; complex cases may take longer for expert interpretation.
Alternatives
Barium swallow shows anatomy but not muscle function. Endoscopy looks at mucosa. EndoFLIP is a newer technology providing some functional information.
Questions to ask your doctor
• Should I stop my reflux medication before the test?
• What if I cannot tolerate the catheter?
• What does my pattern of pressures mean?
Source and review
This guide comes from the Saudi Gastroenterology Association (SGA) patient library, prepared by the SGA Patient Education Panel. Last reviewed: 2026-04-24. It is for education and does not replace your doctor's advice.
Frequently Asked Questions
What is Esophageal Manometry?
Why is Esophageal Manometry done?
What are the risks of Esophageal Manometry?
How do I prepare for Esophageal Manometry?
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