The complex process of swallowing involves a carefully coordinated series of muscle movements that most people never think about until something goes wrong. When problems develop with the esophagus’s ability to move food and liquids to the stomach, an esophageal motility study can provide crucial insights. This sophisticated diagnostic test measures the timing and strength of esophageal muscle contractions, helping doctors pinpoint the source of symptoms like difficulty swallowing, chest pain, or persistent heartburn.

What is an Esophageal Motility Study?

An esophageal motility study, also called esophageal manometry, is a specialized diagnostic test used to evaluate the function of the esophagus. This test measures the strength, timing, and coordination of the muscle contractions that move food and liquids through the esophagus and into the stomach. It uses a thin, flexible catheter equipped with highly sensitive pressure sensors to detect changes in esophageal pressure during swallowing. These precise measurements help doctors identify subtle issues that may not appear in standard imaging tests.

Swallowing relies on a carefully coordinated process called peristalsis, where the esophageal muscles contract in a rhythmic wave to propel food downward. At the base of the esophagus, the lower esophageal sphincter (LES) acts as a gateway, opening to allow food into the stomach and closing to prevent backflow, or regurgitation. When the timing or force of these movements is disrupted, it can cause symptoms such as difficulty swallowing (dysphagia), chest pain, or persistent heartburn.

While tests like barium swallow or upper endoscopy visualize the structure of the esophagus, esophageal motility testing examines how well the esophagus functions. High-resolution esophageal manometry provides detailed, real-time data about muscle activity and pressure changes along the entire length of the esophagus. This sophisticated technology helps doctors evaluate the complex coordination of muscle movements during swallowing, offering insights that can guide treatment decisions for various esophageal disorders.1

Why Are Motility Studies Performed?

Esophageal motility studies help healthcare providers investigate various symptoms related to swallowing and chest discomfort. When patients experience persistent problems with swallowing, chest pain, or acid reflux, these studies can reveal whether the issues stem from problems with muscle function or sphincter mechanics. Gastroenterologists often recommend this testing when other diagnostic methods haven’t provided clear answers. Common reasons for performing an esophageal motility study include:

  • Difficulty swallowing: Problems moving food or liquids through the esophagus, known medically as dysphagia, often indicate potential motility issues.
  • GERD and reflux: Evaluating whether improper lower esophageal sphincter function allows stomach contents to flow back into the esophagus.
  • Chest pain: Investigating unexplained chest pain after cardiac issues have been ruled out, particularly when related to eating or drinking.
  • Motility disorders: Diagnosing specific conditions like achalasia, nutcracker esophagus, or diffuse esophageal spasm that affect normal swallowing function.
  • Surgical planning: Assessing esophageal function before procedures such as anti-reflux surgery or myotomy to ensure the best possible outcomes.

    How Is an Esophageal Motility Study Done?

    Before undergoing an esophageal motility study, patients receive specific instructions to ensure accurate results. For most people, preparation involves fasting for at least six hours prior to the procedure to ensure the esophagus is clear. Patients may also need to temporarily stop certain medications, such as sedatives or nitrates, that can affect esophageal function. A healthcare provider will review any necessary changes to medication routines ahead of time.

    During the test, the patient is seated or reclined while a thin, flexible catheter is gently passed through one nostril into the esophagus. While this sensation can feel strange, most patients tolerate it well with proper guidance from the medical team. Once the catheter is in place, its pressure sensors measure changes in esophageal pressure as the patient swallows small sips of water. These measurements record how the esophageal muscles and lower esophageal sphincter work together during swallowing.

    The procedure typically lasts about 30 minutes, and while some gagging or mild discomfort might occur during catheter insertion, patients usually adapt quickly. They’re encouraged to relax and breathe through their mouth, which can make the process easier. No sedation is used since patient cooperation is necessary to complete the test. The data captured provides valuable insights into esophageal function and can help identify specific motility disorders.2

    After the Study

    Once the esophageal motility study is complete, patients can expect to spend a short period recovering. Any lingering discomfort from the catheter, such as a mild sore throat or nasal irritation, typically resolves within a few hours. Some patients may experience temporary bloating or a sensation of fullness due to swallowing water during the test, but these side effects are minor and usually fade quickly. Most people can resume normal activities immediately after leaving the testing facility.

    The gastroenterologist carefully analyzes data collected about esophageal pressure, muscle contractions, and sphincter function to identify specific issues. This detailed evaluation can reveal problems like weak peristalsis, esophageal spasm, or conditions like achalasia that affect swallowing function. While this analysis takes time to complete, patients typically discuss their results and explore potential treatment options during a scheduled follow-up appointment with their healthcare provider.

    Depending on the findings, some patients may need additional testing for a complete evaluation of their symptoms. Complementary tests might include a barium swallow to visualize the esophagus’s structure, 24-hour pH monitoring to measure acid reflux patterns, or an upper endoscopy to examine the digestive tract directly. These additional diagnostic tools, when combined with motility study results, help create a comprehensive understanding of esophageal function and guide decisions about the most appropriate treatment approach.

    Quality Digestive Healthcare from Cary Gastro

    Symptoms like difficulty swallowing, chest pain, or persistent heartburn can significantly impact your quality of life, but effective diagnostic tools like esophageal motility studies can provide the answers needed for proper treatment. At Cary Gastro, our experienced gastroenterologists specialize in advanced diagnostic testing and personalized care for esophageal disorders. Our team combines state-of-the-art technology with extensive expertise to help identify and treat the root cause of your symptoms. Contact us today to request an appointment and take the first step toward improving your digestive health.


    1https://health.ucdavis.edu/surgery/specialties/gastro/esophageal-motility.html
    2https://health.uconn.edu/gastroenterology/patient-care/patient-resources/esophageal-manometry-instructions/