Duodenal motility (manometric) study
CPT4 code
Name of the Procedure:
Duodenal Motility (Manometric) Study
Summary
A duodenal motility study, also known as a manometric study, evaluates the movement and pressure within the duodenum, which is the first part of the small intestine. It is performed to diagnose issues related to abnormal intestinal movements.
Purpose
This procedure is used to diagnose disorders of intestinal motility, such as gastroparesis or intestinal pseudo-obstruction. It helps in understanding how well the intestinal muscles are working, which is crucial for proper digestion and nutrient absorption.
Indications
- Chronic unexplained nausea and vomiting
- Persistent abdominal pain
- Symptoms of intestinal obstruction without a clear blockage
- Suspected motility disorders like gastroparesis or irritable bowel syndrome (IBS)
Preparation
- Fasting for at least 12 hours before the procedure
- Possibly stopping certain medications that affect gut motility as advised by your doctor
- Pre-procedure evaluations may include a physical examination and review of medical history.
Procedure Description
- The patient will lie down in a comfortable position.
- A thin, flexible tube (catheter) is gently passed through the nose, down the esophagus, and into the duodenum.
- The catheter is equipped with sensors that measure pressure within the duodenum.
- The patient may be asked to change positions or perform specific actions (like drinking water) to assess motility under different conditions.
- The data collected is then analyzed to determine the nature of motility in the duodenum.
Duration
The procedure typically takes about 1 to 2 hours.
Setting
It is usually performed in a hospital or specialized outpatient clinic.
Personnel
- Gastroenterologist
- Trained nurse or technician
- Possibly an anesthesiologist if sedation is utilized
Risks and Complications
- Discomfort or gagging during tube insertion
- Nosebleed
- Sore throat
- Very rare risk of perforation in the gastrointestinal tract
- Mild risk of infection
Benefits
- Accurate diagnosis of motility disorders
- Helps tailor appropriate treatment plans
- Non-surgical, minimally invasive procedure
- Provides detailed information on intestinal function
Recovery
- Patients are typically observed briefly after the procedure for any immediate adverse reactions.
- Instructions may include rest and resuming normal activities shortly after.
- Special dietary and medication guidelines will be given based on the findings.
Alternatives
- Barium X-rays
- Gastric emptying studies
- Wireless motility capsules
- Pros: Alternatives are non-invasive and do not require tube insertion
- Cons: May not provide as detailed information on intestinal pressure and specific motility issues
Patient Experience
- The procedure may be uncomfortable due to the insertion of the catheter through the nose and throat.
- Some patients might experience slight gagging or throat irritation.
- These sensations are usually temporary, and sedation or local anesthetics can be used to enhance comfort.
- Post-procedure, patients may have a sore throat but can typically resume normal activities within a few hours.
Pain management strategies such as mild analgesics can be offered if necessary to ensure patient comfort during and after the procedure.