Esophageal Manometry: What It Is and What to Expect
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor provides Esophageal Manometry?
A gastroenterologist does esophageal manometry. This test is done in a hospital or outpatient center by a specially trained doctor. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What it is
Esophageal manometry is a test to measure how well the esophagus is working. The esophagus is the tube that carries food from your mouth into the stomach. During the test, a thin, pressure-sensitive tube is passed through your nose, down the esophagus, and into your stomach. The test is also called esophageal motility studies or esophageal function studies.
Why a doctor might recommend it
When you swallow, muscles in your esophagus squeeze to push food toward the stomach. The sphincter at the bottom of the esophagus is called the lower esophageal sphincter, or LES. Esophageal manometry is done to see if the esophagus is contracting and relaxing properly. It can also check if the LES opens and closes properly. The test helps diagnose swallowing problems after EGD and imaging tests have not revealed a cause. EGD, also called upper endoscopy, is a test to examine the lining of the stomach and esophagus.
The test may be ordered if you have one of these.
- Heartburn or nausea after eating (gastroesophageal reflux disease, or GERD) and a normal EGD
- Problems swallowing, such as feeling like food is stuck behind the breast bone, with a normal EGD and imaging studies
The test is also used to check for achalasia. Achalasia makes it harder for the esophagus to move food into the stomach.
How to prepare
Common preparation steps include the following.
- Do not eat or drink anything for 8 hours before the test.
- If you have the test in the morning, do not eat or drink after midnight.
- Tell your health care provider about all medicines you are taking, including vitamins, herbs, and supplements.
What happens during it
Before the procedure, you receive numbing medicine inside the nose. This helps make the insertion of the tube less uncomfortable. After the tube is in the stomach, it is pulled slowly back into your esophagus. At this time, you are asked to swallow. The pressure of the muscle contractions is measured along several sections of the tube. The tube is removed after the tests are completed. The test takes about 1 hour.
Recovery
Normal results mean that the LES pressure and muscle contractions are normal when you swallow. Abnormal results may point to achalasia, a problem moving food from the esophagus to the stomach. They may also point to a weak LES, which causes heartburn (GERD). Another possible finding is esophageal spasm, which means abnormal contractions of the esophagus muscles.
Risks and side effects
Risks of this test include a slight nosebleed and a sore throat. A hole in the esophagus, called a perforation, rarely happens.
Call 911 or go to the emergency room if you have trouble breathing, chest pain or discomfort lasting two minutes or more, fainting, coughing up or vomiting blood, or bleeding that will not stop.
Who performs it
A specially trained doctor called a gastroenterologist does the test in a hospital or outpatient center.
Common questions
How long does esophageal manometry take?
The test takes about 1 hour.
Does esophageal manometry hurt?
You may feel discomfort in your nose and throat during the test. You may also have a gagging sensation when the tube passes through your nose and throat. Numbing medicine is put inside the nose first to make the tube less uncomfortable.
Can I eat before esophageal manometry?
You should not have anything to eat or drink for 8 hours before the test.
How does a direct primary care or concierge doctor fit in?
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
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Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
