About Your Esophageal Manometry

This information will help you get ready for your esophageal manometry (ee-SAH-fuh-JEE-ul muh-NOM-uh-tree) procedure at MSK.

An esophageal manometry measures how your esophagus (food pipe) works. This is done to find out why you have symptoms such as trouble swallowing or pain when swallowing. It is also done to find out why you have chest pain.

If you are having anti-reflux surgery, you may have an esophageal manometry within the month before.

You do not need general anesthesia for this procedure. General anesthesia is medication to make you fall asleep during surgery.

1 week before your procedure

Ask about your medications

Talk with your healthcare provider if you take any of the medications in this section. You might need to take a different dose (amount). You might need to stop taking some of them before your procedure. These can affect your procedure or results.

Do not change your dose or stop taking your medications without talking with your care team first.

Anticoagulants (blood thinners)

Blood thinners are used to treat blood clots. They are also used to prevent a heart attack or stroke.

Examples of common blood thinners are listed below. There are others, so be sure your care team knows all the medicine you take. Do not stop taking your blood thinner without talking with a member of your care team.

Benzodiazepines

Benzodiazepines (BEN-zoh-dy-A-zeh-peens) are used to treat anxiety, sleep disorders, and seizures. Examples include alprazolam (Xanax^®) and diazepam (Valium^®).

Antispasmodics

Antispasmodics (AN-tee-spaz-MAH-dik) are used to help manage muscle problems such as muscle spasms. Examples include methocarbamol (Robaxin^®), tizanidine (Zanaflex^®), and cyclobenzaprine (Flexeril^®).

Opioids (narcotics)

Opioids (also called narcotics) are used to treat pain. Examples include oxycodone (OxyContin^®), hydrocodone with acetaminophen (Vicodin^®), and tramadol (Ultram^®).

Promotility agents

Promotility (proh-moh-TIH-lih-tee) agents help empty your stomach more quickly. Examples include metoclopramide (Reglan^®), erythromycin (E.E.S.^®), domperidone (Motilium^®), and prucalopride (Motegrity^®).

Diabetes care

You may need to take a different dose of diabetes medication than usual. This includes insulin and other diabetes medications. Ask the healthcare provider who prescribes your medication what to do the morning of your procedure.

3 days before your procedure

An endoscopy nurse will call you 3 days before your procedure. They will confirm the type of procedure(s) you are having. They will go over your instructions with you.

The nurse will ask questions about your medical history and the medications you take.

2 days before your procedure

You may need to stop taking the following medications 2 days before your procedure.

• Benzodiazepines
• Antispasmodics
• Opioids (narcotics)
• Promotility agents

Remember, do not change your dose or stop taking your medications without talking with your care team first.

1 day before your procedure

Note the time of your procedure

A staff member will call you after noon (12 p.m.) the day before your procedure. If your procedure is scheduled for a Monday, they will call you on the Friday before. If you do not get a call by 7 p.m., call 212-639-5014.

The staff member will tell you what time to get to the hospital for your procedure. They will also remind you where to go.

Visit www.msk.org/parking for parking information and directions to all MSK locations.

Call the healthcare provider who scheduled your procedure if you need to cancel for any reason.

Instructions for eating

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Stop eating at midnight (12 a.m.) the night before your surgery. This includes hard candy and gum.

If your healthcare provider told you to stop eating earlier than midnight, follow their instructions. Some people need to fast (not eat) for longer before their surgery.

The day of your procedure

Instructions for drinking

Between midnight (12 a.m.) and 2 hours before your arrival time, only drink the liquids on the list below. Do not eat or drink anything else. Stop drinking 2 hours before your arrival time.

• Water.
• Clear apple juice, clear grape juice, or clear cranberry juice.
• Gatorade or Powerade.
• Black coffee or plain tea. It’s OK to add sugar. Do not add anything else.
  • Do not add any amount of any type of milk or creamer. This includes plant-based milks and creamers.
  • Do not add honey.
  • Do not add flavored syrup.

If you have diabetes, pay attention to the amount of sugar in these drinks. It will be easier to control your blood sugar levels if you include sugar-free, low-sugar, or no added sugar versions of these drinks.

It’s helpful to stay hydrated before surgery, so drink if you are thirsty. Do not drink more than you need. You will get intravenous (IV) fluids during your surgery.

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Stop drinking 2 hours before your arrival time. This includes water.

Things to remember

Only take the medications your care team told you to take the morning of your procedure. Take them no later than 2 hours before your arrival time. You can take them with a few small sips of water. Do not drink anything starting 2 hours before your scheduled arrival time.

What to bring

• A list of the medications you take at home.
• Medication for breathing problems (such as an inhaler), if you take any.
• Medication for chest pain, if you take any.

Where to go

Your procedure will take place in the Endoscopy Suite at MSK, located at:

1275 York Avenue (between East 67^th and East 68^th Streets)
New York, NY 10065

Take the B elevator to the 2^nd floor. Turn right and enter the Endoscopy/Surgical Day Hospital Suite through the glass doors.

Visit www.msk.org/parking for parking information and directions to all MSK locations.

What to expect when you arrive

Many staff members will ask you to say and spell your name and birth date. This is for your safety. People with the same or a similar name may be having a procedure on the same day.

During your procedure

A staff member will bring you into the procedure room. A member of your care team will put an anesthetic (numbing) gel in your nose. They will do this with a cotton swab (Q-tip^®).

Your doctor will pass a thin tube through your nose once your nose is numb. The tube will go into your stomach. You might have some mild gagging or discomfort. These feelings will go away quickly.

Your doctor will ask you to swallow small sips of water once the tube is in place. The muscles in your esophagus will contract (tighten) as you swallow. The tube will measure how strong the contractions are in different parts of your esophagus.

Your care team will take out the tube after your procedure is done. Your procedure will take about 15 minutes.

After your procedure

You can leave the hospital right after your procedure. You do not need to follow any special instructions.

When to call your healthcare provider

Call your healthcare provider if:

• You have a fever of 101 °F (38.3°C) or higher.
• You have trouble swallowing.
• You have pain in your chest.
• You have pain in your abdomen (belly).
• Your abdomen feels harder than usual or is bloated (swollen).
• You feel nauseous (like you’re going to throw up) or you vomit (throw up).
• You have a very bad nosebleed or a nosebleed that does not stop.
• You have any unexplained or unexpected problems.