Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report
CPT4 code
Name of the Procedure:
Esophageal Motility Study / Manometric Study of the Esophagus and/or Gastroesophageal Junction
Summary
An esophageal motility study (EMS) is a diagnostic test that assesses the function of the esophagus and the muscles involved in swallowing. It measures the pressure and movement of esophageal muscles to determine if the esophagus is working properly.
Purpose
This procedure is used to diagnose conditions like acid reflux, difficulty swallowing, and esophageal spasms. The goal is to identify any abnormalities in muscle function or coordination that might be causing symptoms.
Indications
- Persistent heartburn or acid reflux (GERD)
- Difficulty swallowing (dysphagia)
- Chest pain not related to heart conditions
- Suspected esophageal motility disorders such as achalasia or esophageal spasms
- Preoperative assessment for anti-reflux surgery
Preparation
- Patients are usually advised to fast for 6-8 hours before the procedure.
- Certain medications may need to be adjusted or temporarily stopped as advised by the doctor.
- Any prior diagnostic tests like an upper endoscopy may be reviewed beforehand.
Procedure Description
- The patient will sit upright or lie on their side.
- A thin, flexible tube (catheter) is gently inserted through the nose and guided down into the esophagus.
- The catheter contains sensors that measure pressure at various points along the esophagus.
- The patient will be asked to swallow small amounts of water to assess esophageal muscle function.
- The data collected is analyzed to evaluate the coordination and strength of esophageal contractions.
- The test typically causes minimal discomfort but can induce a gagging sensation.
Duration
The entire procedure usually takes about 30 to 45 minutes.
Setting
Esophageal motility studies are generally performed in a hospital's outpatient department or a specialized gastroenterology clinic.
Personnel
The procedure is conducted by a gastroenterologist with assistance from trained nursing staff.
Risks and Complications
- Minor discomfort or gagging during tube insertion
- Mild nosebleed or sore throat post-procedure
- Rare risk of esophageal perforation
- Infection, though extremely uncommon
Benefits
- Accurate diagnosis of esophageal motility disorders
- Tailored treatment plans based on precise findings
- Improved symptom management and quality of life
Recovery
- Most patients can resume normal activities immediately after the procedure.
- Light meals can be consumed, and normal diet resumed as advised.
- Follow-up appointments may be scheduled to discuss test results and treatment options.
Alternatives
- Barium swallow (esophagram)
- Less invasive but might not provide detailed information on muscle function
- Esophageal pH monitoring
- Focuses on acid exposure rather than muscle activity
Patient Experience
- During the procedure, you may feel discomfort or a gagging sensation as the tube is inserted.
- Local anesthesia might be sprayed into the nose or throat to ease discomfort.
- Post-procedure soreness in the nose or throat can be managed with over-the-counter pain relief if necessary.
By understanding what to expect, patients can approach their esophageal motility study with greater confidence and clarity.