Oesophageal manometry is a test at Great Ormond Street Hospital (GOSH) to measure how well the muscles and nerves in the oesophagus work.
The oesophagus is the tube that takes food from the back of the mouth to the stomach, and the muscles here squeeze to push food downwards. A catheter (plastic tube) is inserted into your child’s digestive system through their nose. When your child swallows the nerve and muscle activity is picked up by sensors contained in the catheter and are recorded on a machine.
Why is it needed and are there any alternatives?
Your child needs this test so the doctors can check how well his or her muscles and nerves are working to squeeze food and drink through their oesophagus.
What happens before the test?
You will already have received information about how to prepare your child for the test in your admission letter.
If your child is taking domperidone, erythromycin, bacflofen or metoclopramide please stop them 72 hours before the day of the test.
Please do not stop any medications without first checking with a doctor. The doctors will explain about the test in more detail, discuss any worries you may have and ask you to sign a consent form giving permission for your child to have the test. If your child has any medical problems, particularly allergies, please tell the doctors about these. Please also bring in any medicines that your child is currently taking and show these to the doctor.
Your child may have the catheter placed under general anaesthetic or awake. If they are having the test under anaesthetic, a thin tube (cannula) will be put into a vein prior to the procedure. This will be assessed by the pre-admission nurse in conjunction with medical staff, and then explain to you what they think is most appropriate.
What does the test involve?
You and your child will be taken to the Gastroenterology Investigation Suite where the test will take place. There will be a nurse or doctor with your child all the time.
The nurse or doctor will put the catheter into one of your child’s nostrils and pass it down the back of his or her mouth into the oesophagus. This does not hurt, but it may be uncomfortable. Your child may cough, sneeze or gag if they are awake when the catheter is passed. If your child requires an anaesthetic, the catheter will be passed at the same time as the gastroscopy (thin tube with a light and camera on the end).
The catheter will be taped to your child’s cheek to stop it from moving. Once the catheter is in the correct place in the oesophagus, your child will go through to the recovery area. When it is safe to do so, you will be called to be with your child. If your child is awake when the catheter is passed then you may stay with your child for the entire time.
When it is time to start the test the other end of the catheter is attached to a machine, which measures how well the muscles and nerves are working.
During the test your child will need to drink and then eat something. If your child is having this test because food gets stuck, it is a good idea to bring a food that typically gets stuck with you. If your child has food allergies, you may wish to bring something that they like with you.
However, there is a special diet kitchen that can prepare food for allergies. Please inform the nurse on your arrival if your child will require a special meal.
Are there any risks?
The main risk with this test is that your child could have a nosebleed when the catheter is put into their nostril. This tends to happen more with children who have nose bleeds anyway. There is very small risk the catheter could damage your child’s oesophagus. However, this is very unlikely as the catheter is flexible and the doctors and nurses who do the test are very experienced.
If your child is having an anaesthetic for this test, their sleep pattern may be altered for up to 48 hours after the test. The time it takes to recover from an anaesthetic varies from child to child – encourage your child to rest if they are still sleepy the following day.
As your child had nothing to eat or drink for some time before this test, there is a small chance that he or she may be mildly dehydrated afterwards. While on the ward and also once you get home, it’s a good idea to encourage them to drink as frequently as possible. This will also help to reduce the effects of the anaesthetic.
Symptoms of dehydration include dry lips, pale skin, sunken eyes, not passing urine. It may be sensible to keep your child off school for a day following the test, to allow them time to recover. Keep a close watch on your child until you feel happy that they are fully recovered. Do not leave them alone.
What happens afterwards?
After the test, the nurse or doctor will remove the catheter and your child will return to the ward. Unless your child vomits, once they have passed urine, and as long as no other tests are planned, the cannula will be removed and they will be able to go home.
When you go home
You should call your GP or your local hospital if your child:
becomes generally unwell
refuses to eat or drink
is unusually sleepy or it is difficult to wake them up.
How long will it take to get the results?
Your child’s test results will be given to you at your child’s next outpatient appointment at the hospital. The analysis of this test is complicated so may take some time to get the results. However if they need to start on new treatment before the appointment the hospital will contact both you and your child’s family doctor (GP) with details.
Please note this is a generic GOSH information sheet. If you have specific questions about how this relates to your child, please ask your doctor. Please note this information may not necessarily reflect treatment at other hospitals.