91020 Gastric motility (manometric) studies

Name of the Procedure:

Gastric Motility (Manometric) Studies

Summary

Gastric motility studies are diagnostic tests used to measure the movements and pressures within the stomach, which helps assess how well it is working. The test involves placing a thin tube with sensors into the stomach through the nose. This collects data on muscle contractions and other movements.

Purpose

Gastric motility studies are conducted to diagnose conditions related to abnormal stomach muscle function, such as gastroparesis, functional dyspepsia, or other motility disorders. The goal is to understand the underlying cause of symptoms like nausea, vomiting, bloating, or abdominal pain, to tailor appropriate treatments.

Indications

• Chronic nausea and vomiting
• Unexplained bloating and early satiety
• Persistent abdominal pain
• Suspected gastroparesis or delayed gastric emptying
• Evaluation of functional dyspepsia

Preparation

• Fasting for at least 8 hours before the procedure
• Temporary cessation of certain medications, as instructed by a physician
• Completion of any required diagnostic tests, such as blood work or radiographic studies

Procedure Description

1. A thin, flexible tube (catheter) with pressure sensors is lubricated and inserted through one nostril.
2. The tube is gently advanced through the esophagus into the stomach.
3. The patient may be asked to change positions or eat a small meal to assess stomach function under different conditions.
4. The pressure and muscle contractions are measured by the sensors and recorded for analysis.
5. The tube is then carefully removed.

Common tools include the manometry catheter and a data recorder. The procedure typically does not require general anesthesia, but a local anesthetic spray may be used to numb the nasal passage.

Duration

The procedure usually takes about 1 to 2 hours to complete.

Setting

The test is typically performed in an outpatient clinic or a hospital's gastrointestinal motility lab.

Personnel

• Gastroenterologist or specialist trained in motility studies
• Registered nurses or medical technicians

Risks and Complications

• Discomfort or gagging due to catheter insertion
• Nasal or throat irritation
• Rare bleeding or infection at the insertion site
• Possible inaccurate results if the patient has difficulty tolerating the procedure

Benefits

• Accurate diagnosis of stomach motility disorders
• Tailored treatment plans based on detailed diagnostic information
• Potential improvement in symptoms and quality of life after treatment

Recovery

• Patients can usually return to normal activities immediately following the procedure.
• Patients may experience mild throat discomfort, which typically resolves within a few hours.
• Follow-up with the gastroenterologist to discuss results and treatment options.

Alternatives

• Gastric emptying studies using radioactive markers
• Endoscopic evaluation
• Medications to manage symptoms without detailed motility assessment

Each alternative has its own benefits and limitations. For instance, gastric emptying studies give different kinds of information and can be less direct than manometry but may be easier to tolerate.

Patient Experience

Patients may experience some discomfort from the insertion of the catheter but will be supported throughout the procedure by healthcare professionals. Some might feel anxious or gag during the insertion but can expect the process to be quick. Afterward, throat irritation or mild nasal discomfort may occur, but these symptoms are generally temporary.