Esophageal Manometry Demonstration
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- Опубликовано: 18 май 2012
- HealthPartners Digestive Care Center
(651) 254-8600
UPDATE from 2019: Hey everybody! WOW! 100,000+ views! I'm continually amazed at how many people are looking for information on this test. I hope you find this video helpful and that it makes the whole thing a little less scary.
I just rewatched the video in its entirety for the first time in a while. The content is, at its core, still good and current. One major change that's happened is the size of the reflux monitor (the square box in the last 3rd of the video) is now significantly smaller. It's around 1/3 the size of that original behemoth. (Man, that thing was HUGE!) The wire probe size/diameter is still about the same, but the recording box you take home with you will be significantly easier to manage.
...and my wife says I have less hair... :-D
Take care, everybody!
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Thank you for being the one who does the procedure who is actually willing to show us how it's done in your own body. Thanks for taking the time to explain and share. Very helpful.xx
Just had both of these tests done. They are absolutely brutal I have no idea how this guy can sit through them with ease.
Very interesting. Thank you for your candid humor during this. I think it's easy for doctors to forget how scary it is to have all of these tests done, so it was exceptionally nice of you to show us a personal experience.
Oh my gosh.....I'm so glad I found this video because I would not have been mentally prepared for what I will be experiencing soon. I know it's an older video, but if the creator notices my comment, please know that I appreciate you very, very, much for helping me work through my anxiety about this. I can't thank you enough...
Great! Can you please share your experience with us? How was your test? Because I have my appointment on coming monday. Even i have a anxiety issue and i am worried about my Throat Larynx while insert the tube. If its hurt? Is pain is there in Nose and Larynx after Test?
Do not worry it is nothing to get worked up about. Had it done myself. 30 mins all done no biggie
All Glory be to God I thank God for Jesus I had this test done. Yesterday Jan 9 2020 on a Thursday my nurse was a blessing she encourage me also you have to stay focus on your breathing and when turn around and seen my face she,ask why smiling?I'm just trusting in God ..i know better days are coming and the next thing it was already done 15min no more 20 thank God for his promises you can do it ... people we can trust in God !!!in Jesus name..... stay pray up
I think that was thanks to the doctor but ok
What did you get the test for difficulty swallowing?
I had mine done yesterday after watching this video about a hundred times to prep myself. I was numbed really well, and insertion was pretty easy. The nurses had trouble getting it inserted at the right length, so they pulled it in and out a couple inches a few times, trying to get it right. That made me gag, but it wasn't terrible. The gagging stopped when they taped it still on my nose. I didn't have trouble with not swallowing between swallows. I was scared to death going in thanks to comments here and elsewhere, but it wasn't that bad. If you have one coming up, don't work yourself up too badly. You'll make it!
Thank you for the informative film. My wife was very anxious about this test and your demo calmed her significantly.
Thank you so much for your video! It really helped me to not be as nervous about the proceure. I had the procedure done today. I gag very easily, so it was a bit rough getting the tube inserted - I had the nasal Lidocaine, but no throat spray. I remembered what you said about controling your breathing and I was able to make it through the test without a problem. I told the facility about your video and they are planning to tell their future patients about it. Again - thank you very much!
I had this test done yesterday. I read all the negative comments on here and other sites and was convinced this was going to be horrible. This test was super easy! I was done in 10 minutes and didn't gag once. I think the people that made such a fuss either had it done with someone that didn't know what they were doing, or they psyched themselves into making it worse. There were a couple things different than this video, but essentially it was done the same. You just feel pressure from the tube in the nose and then once it goes down a bit further in the throat you get a tight feeling like a metal stick is stuck in there. If you just keep breathing through your mouth and listen to what they say you should be fine. It is not fun, but it is over quick and if you need the test to find out what is wrong then just make the appointment and skip reading about it.
Wow. Thanks a bunch for demonstrating the procedure on yourself. Much appreciated.
This guy is a hero! How can you be talking in this kind of situation?
Mary -
Thank you for your kind feedback. I am so pleased to have been a help, but kudos to YOU for getting it done! You're awesome! I hope it helps your doctor put together some answers that are helpful.
Your thoughtful comment is a real feather in my cap! ;-)
Blessings!
Thank you for this information, so helpful for nursing school. Also, glad you are well and still uploading videos!
Thanks for the video! It prepared me for the manometry I had scheduled today.
As someone with Achalasia it really wasn’t so easy for me. I gagged and spluttered and felt like I was being water boarded. You take it like a champ though!
Thanks! I'm glad to have made the prospect of the test less daunting. That's the hope. Best wishes!
This is amazing. Thank you so much for posting.
Thank you so much for this informative video. Your video was the best that I could find. I’m going on Wednesday for my test. I am going to tell the nursing staff about this video. So others hopefully will watch this as well. Take care :)
Thank you so much for this instruction! Had the pH test long time ago.
I had that done and only had 20 per cent! After the tube kept coming out, I had to be scoped using Propofol anesthesia and the tube had to be sutures into my stomach because, surprise, surprise, I had a Tortuous Esophagus, as well!! Big discovery. Also, stomach full of polyps from 25 yrs of PPI, Prilosec. Excellent instruction! Thank you! Wish mine had gone as well.
Really well explained and thoughtful video. Thank you ever so much for making this.
this vid helped me feel less anxious and is worded and explains so well thank you :)
Currently I'm a med student, and right now I'm studying esophageal diseases. As I kept reading my class material, I would read about esophageal manometry over and over again, but I had no idea what it was all about. Thanks to you and your video, now I know. Have a great day. ;)
I think the med students should have to experience this test first hand so they know what their patients go through. It might build more trust and empathy.
Agree. I felt like my nurse was ham-handed. I would never do this test again.
Hey Miriam -
Two sugguestions: 1) Ask your physician to pre-order some anti-nausea medication to be given prior to the procedure, and; 2) During the test, concentrate on continuous breathing. Directed breathing helps surpress wretching associated with nausea. Sometimes it takes quite a bit of "mind over matter" to control your breathing and keep the wretching under control, but you can do it! You don't have to think much during the test -- just go to a "happy place" and breathe. :-)
Yeah right like I sad id rather have someone shoot me in the head than going trough this again and I am dead serious!
So far, I did the bravo ph test for 48hr at Mayo Clinic, MN. The result showed the I have mid acid reflex so my doctor asked my to do Esophageal Manometry test. The bravo test is about wireless capsule attached to esophagus by scope. It went so easily but I had mild pain when sawing on the second day. I will do the manometry next week at Mayo Clinic I hope this test goes smoothly as the ph exam. I will update after I did the test.
Thanks, your video was so helpfull.
Some times we as students dont really get how things are done in the clinic or hospital. We might get the idea but its nice to see the acctual procedure.
Thanks a lot
GRACIAS AMIGO
great video. I am a new CST and will be helping out in endo next week and this has given me a great heads up on Manometry
Having this done 12/11/15, so your video helped me to get my mind wrapped around it.
Glad to hear it! That's the hope!
Thank you for your well and easy to understand video!
Thank you so much for posting this awesome video! I'm scheduled for an esophageal manometry test next week, which I'm quite nervous about. Im also a nurse, so I have a good clinical understanding of the procedure (hence my nervousness!). But your experiential video has been most helpful in easing my nerves. So thank you, thank you, thank you! I still think I'm gonna take a bit of Xanax first though!
Glad to help! Best wishes!
Good thing I am calling early tomorrow and canceling this! This IS torture! I had nissan fundoplication hiatal hernia surgery 10 months ago and that was bad enough! Thank you for the fore warning!!
i have to get this just to get hietal hernia surgery 🤦🏻♀️
@@amandiablack9155 Me, too. I went two weeks ago and the nurse couldn't get the probe down due to swollen sinuses. I'm in such a state of anxiety because I have to go back in 3 days to try again. I feel sick just thinking about it. Maybe I'll just live with the hietal hernia.
@@leslielewis7286 l would as well after seeing that. I just went last week for a Scan and Doppler if this is the next step there's no way on the planet their doing that to me!
@@amandiablack9155same
Had it done today!! They did NOT give any numbing spray in my throat! Felt like I had to swallow with a stiff string of pearls. Miserable test! Think it would have been much more bearable with throat spray. Oh and not only was I their ONLY patient but I was also their VERY FIRST PATIENT to use the new equipment on. 😳 My test took an HOUR while one of the 3 techs read the instructions off her cell phone to the tech performing the procedure. Yeah….never want a repeat that process. I’m pretty tough and can talk myself through a lot, but I was praying not to have a panic attack. 🤦🏼♀️😰
Anyway…I lived through it…obviously. 🤷🏼♀️🤪🙌🏼✝️🙌🏼
You're welcome and best of luck with your studies!
I had this done and am an RN also. Old nurses trick learned years ago! To stop swallowing put the tip of your tongue touching just past your upper front teeth with the rest of tongue will be up against front of the roof of your mouth keeping bottom jaw relaxed until you need to swallow upon command again! Keep you shoulders dropped and relaxed! Also it was shown but not said, tip your head forward some with chin slightly tipped down. Makes passing of the tube easier. This really helps a lot!! :)
Thank you for the tips! Getting it done in 2 days...Nervous..
I've actually incorporated this into my coaching for patients. Thanks!
getting it done tomorrow 😞 ill try this
@@amandiablack9155 how was it?
@@SissyD61 how was it?
I'm sorry to hear that. It doesn't have to be that way. It's VERY uncomfortable without any numbing agents. It feels like someone is sticking their finger right up your nose! (I've done it both ways and I'd NEVER submit to doing it without numbing medication unless it was absolutely necessary, and I can't think of a reason when it would be absolutely necessary.)
If that clinic staunchly refuses to use some lidocaine jelly, look for another clinic that will.
Hace una semana, me hicieron este procedimiento. Fue algo muy perfecto, nada del otro mundo. Agradecida con quienes lo practicaron. Todos con mucha experiencia. Cierto se necesita una cantidad extraordinaria de concentración.
Estoy muy agradecida y en espera de buenos resultados.
Thanks
This tape help me prepare for my test. It went well for me. Little uncomfortable but tolerable. I think for me all I could do was do my best to relax and breathe. I thought I was going to Gage once but I tried to think about something else.
The only problem with doing this process while sedated is the sedation medications can over-relax your esophagus muscles and not give a true reflection of how things are working.
I'll encourage you to talk with your doctor about doing the test after having taken an anti-anxiety aid. With some good coaching and a patient nurse, you should be able to get the test results you're looking for.
Best of luck, and I hope you feel better soon.
Lo
This is HELPING ME Sooooo Much!
Excellent! Glad to help!
Thank you for doing this video
Excellent video!!
The 24hr manometry is really fun, and I've had done 3 times now ...... oh joy. Sleeping with it in place is great fun.
🎉sound like a party 🎉
sooo educational, thank you!
First, Peter, you are a good sport! Thanks for explaining it while it was happening. I felt too panicked when I had it done, so I'm impressed.
I did this 8/16 and was diagnosed with Achalasia 2. It took a lot longer than 10-15 minutes and I needed to hold a barf container because I threw up several times when they were getting the tube down. I don't remember swallowing with water while we did it. The best advice was to breath to relax, yoga style, and put your tongue so it touches the front near the teeth. It's something to focus on and relieve pressure. I had to redo several swallows because I kept swallowing at the wrong time! Can the tube be inserted under twilight? I may ask for that next time.
Sweet vid champos! I'm actually have way through the second one now. There's discomfort it is plenty bearable, hardest thing to get used to is swallowing food. Only 8 hrs left Yeeeeaaaww Go Queensland!
This puts a lot into perspective.
Yea, makes all the panzies that are commenting look even more ridiculous !
Thank you. This has been very helpful. :)
Great video thank you
Had mine done and trust me no numbing gel no spray no nothing. And it hurt like hell.
He is a pro I had mine done today and couldn’t stop gagging ! It was so uncomfortable whew I wouldn’t want that done again
I don't care how easy you make this sound, it still sucks. I couldnt stop gagging and swallowing even though I needed to stop swallowing. Lol. This is an important video though. Well done on explaining it well.
I bet you felt like a real lion watching this video ... lol
Thanks for your kind words in spite of your difficult experience. I know it can be tough and everybody tolerates it differently. Some patients' gag reflex is just too "healthy" for this test to work well. For those folks it takes an extraordinary amount of concentration and "mind over matter". I really feel for them, and you. I hope your doctor was able to get enough data to make a diagnosis or can figure out a good alternative. Take care!
Thank You! ❤
Thank you!!
Some years ago when I was first diagnosed with GERD, I had a gastroscopy and had no idea, until the time of insertion, about the diameter of the tube going directly down my gullet through my mouth. At the time I had the throat numbing spray applied and that was almost as bad as the procedure itself. If I'd known what was to happen I'd have swerved it without doubt and since then I've had probes in virtually every orifice without an issue. (I was diagnosed with Prostrate Cancer in 2013 so you can imagine the areas I'm talking about).
More recently I had cause to have a second gastroscopy and believe me, the tube is larger in diameter than those shown in this video. This time, I asked to be put under general anaesthetic and so for the procedure i felt nothing.
Going under isn't an option for the above procedure and I went for mine earlier today because I'm desperate to have the repair op to my sphincter. (My Lanzaprozole has been having no effect on my GERD for a year or two now so I had no choice if there was to be any chance of having the op)
The initial 10-15 minute procedure uses a smaller tube than that used in a gastroscopy as it's carried out through the nostril and with bad memories of the numbing gel and spray from my first procedure some years ago, I opted to go without.
The tube was passed down with a little discomfort and I swallowed down into my oesophagus with water to, I'm guessing, midway to the sphincter, I was then told I cant swallow any more water and the next push of the tube the nurse carried out had me reaching for the tube which I yanked out because I swallowed without the water.
Now, had I read this and adopted the tongue between the teeth tip, I'd have managed to carry on and wish a nurse had told me this beforehand.
Next up was the 24 hr PH manometry test shown also on this video and again I had no numbing spray and given the much smaller diameter it was a cinch compared to the previous sized tubes. I have it in right now and return tomorrow to hand over the digital recorder and have the tube removed although with the strength of acidity I suffer these days, it may have melted away by then :-)
So, I'd echo the holding your tongue between your front teeth for the initial test because to swallow without water with this size tube down your oesophagus, regardless of having a throat numbing spray or not, isn't a pleasant feeling. My pinion?, dont have the numbing spray or Gel for either of the above. The second insertion is a smaller tube and you can hardly feel it going in apart from the initial push pst your nostril and all the time you are free to drink water to help it pass down. Right now, as I have it in, I can't feel very much at all so it really isn't a procedure to worry about.
Thank you! Getting it done in two days. Nervous wreck.
Yeah gastroscopy and manometry are both different. I too was shocked when I first had a gastroscopy, the camera was much larger than I had imagined. The key is try your best to relax and breathe!
Thank you for the video. Getting it done in two days but they said that it would take 2-3 hours. Not sure why. Nerves are definitely kicking in. Have had many NG Tubes and they felt like a garden hose. (Crohn's Disease, then Grade D Esophagitas sp.) Think it's coming back because it hurts to swallow, even my meds.
Great! Glad it was helpful!
THANK You
Just had it done...1st time and last time lol.
Agree. They broke me with this test.
Both of u had GERD?
@@taim989 I had 6 instances of coughing up gastric acid in the middle of the night over two years. Esophageal manometry was ordered in preparation for HH repair.
After all the torture of manometry, I have refused surgery. I am 67 yo. I don’t have any faith that I will recover well. And I fear the failure rate for HH repair is too high.
I may be forced to have HH repair in the future, but I damn sure will not agree to manometry again.
@@MarionBurgwin-bk6ey how are you doing nowadays ? since the hiatal hernia is not fixed how are you managing with the pain and refluxes i bet you are suffering even before the surgery ..God be with you , my grandma recently developed diaphragmatic hernia (maybe just like your case ...) and she is planning for the surgery
@@taim989 Actually very well! I take Prilosec 2x/day and iron + C. I follow the boiler plate HH suggestions about elevating the head at night and smaller, more frequent meals etc. I would not know I had a large HH hernia. I am going to avoid surgery if o can.
Thank you Doctor , that was interesting I will be getting a test next week. My Dr. said my esophagus was swollen , but because I stated chocking and gagging on my food.it’s hard for me to swallow, I have to eat very slowly and small bites and drink water between bites , so the food goes down ok. It’s been happening more, so will see what the results will be.
I think it’s called my Catcher which opens and closes, closed up on me one time when I had a small drink of coffee and my husband made me laugh. It was a very terrifying scare, I thought I was going to die, because I couldn’t breath . And the doctor doing the procedure said, it was probably heartburn.
I am taking Omeprazole 20 mg.
But, thank you for your positive information, I just told you my story. Thank you so much and God bless you.
I had one done last year. It wasn't so bad you guys. It sounds and looks more terrible than it actually is.
I watched this video several times in preparation for my manometry test yesterday (May 17th, 2017)...a prerequisite for the Nissen Fundoplication surgery. This video was helpful but not every place does it the same way. Mine took place in St. Cloud, MN. There was NO numbing gel or spray and I was told it's because of possible false readings. The manometry tube is 1/8 inch in diameter...very small, like the size of a spaghetti noodle or so. The RN tech lubricated the end of the tube and inserted through one nostril and indeed I swallowed water to help the tube down after it got to a certain point. The nostril did sting quite a bit at first and then when it got to the throat (by the thyroid area), the tube got "caught up" a little bit...coiled a bit and it was hurting so the RN eased the tube back a little, trying to get the tube straightened out and yeah, it was fine. After the tube was exactly where it needed to be, the RN administered a little water for me to swallow every 30 seconds about? I did 11 swallows in all. Yes...try not to swallow after you swallow that water they administer. Wait for the next one to swallow. I have anxiety so making it through this test surprised me! LOL! But, I can tell you...this test is NOT as bad as you might think! Truly...the tube is so small in diameter! I didn't even have numbing stuff and I made it through! The whole process for me was about 25 minutes.If I can do it, you can do it!
Scruffy Scrubs Hello, I need to do this test soon and I'm seriously freaking out. The worst things I'm worried about are the gag reflex and the feeling of suffocation. Did you experience any of these?
Ailisea hi and I was a bit nervous too but the tube is so small and goes way back I'm your throat that it didn't make me gag at all. don't fear it...truly it's not as bad as we make it out to be! Good luck.
Scruffy Scrubs Thank you so much, I hope I'll be able to do it too... I read so many people saying it was the scariest thing in their life and I got scared as well.
Scruffy Scrubs Oh and so they didn't give you any numbing spray or gel for your throat and nose?
Ailisea no, it really isn't a big deal. I was told that numbing agents can interfere with the results of the test.
Excellent video. Wish me luck. :)
This is in my near future as I am being referred for Linx. I had the pH already and that was awful. It stuck to the inside of my nose and hurt like hell for 24 hours. All I could do was cry and when it was removed I had the worst nosebleed and was hysterical.
I just left, and will never do that again. It never would go down right. After 3 attempts I gave up.
The second time I had this test done it was a cakewalk. The FIRST time I had it, it took them an hour and a half to get the probe placed and I'd chugged so much water it looked like I was pregnant. XD
I truly believe to get the best nurse for this procedure. I had a nurse who has done this procedure for 20 years. A real pro
Thanks for the video. I have 2 hours to go before the tube is removed. your video helped lower my anxiety. I went to the Mayo Clinic in Jacksonville, FL. They do not use the numbing spray because they think it might interfere with the testing. On a scale of 1-10 for discomfort I would rate putting the tube in 4, wearing it for 24 hours a 1.
What a great video. I watched this before having my manometry and it made it much less daunting. There are so many negative videos on the net about this procedure, but this is definitely the most realistic to the actual experience. Ignore the hyperbole.
I had it done 3 weeks ago. While it's not fun, I had no trouble. Wish they would have numb the throat but I tried to swallow that numbing gel in the nose to my throat. I felt like I had a bone stuck in my throat. But it was just uncomfortable but not awful. I didn't feel gaggy but I did do slow breathing. Helped. There was some slight pain when I swallowed but like I said it felt like a chicken leg bone in throat but I managed just fine. After it was removed, I was just fine. Don't let anxiety get to you. I really put myself into a state which in the long run it was unnecessary . Good luck to all
I did not get a numbing spray in my throat, just the stuff in my nose. Nothing helped suppress my gag reflex or the desire to swallow... I threw up all that lovely saline solution and had to do about 20 swallows because I couldn't get the proper readings, it was the worst experience of my life so far. I had a 30 minute panic attack afterwards :(
Great video that explained it well. I just recently had my doctor order this test so I will have it done soon. My concern is that I have been having constant nausea, most recently it has been pretty severe and it usually gets worse any time I have had that numbing gel in the past for other procedures. Does anyone have any suggestions as to what might help me get through it?
I just did this...and honestly thr worst part was the numbing spray and a few hours after. I felt sick to my stomach and my throat was killing me for 3 hours
Had it performed last week. The worst part is the initial 1-2 minutes of having the tube in your throat and fighting the gag reflex. Once you control that and relaxing(key) it becomes merely vaguely uncomfortable. The person administering the test is usually not the person that interprets and delivers the results. BUT , lol, mine accidentally said "wow" twice. And the results came back as Jackhammer Esophagus. Explains why I feel like I'm having heart attacks when I swallow. For me the insertion was barely uncomfortable, the next 30 secs sucked ass till I relaxed my gag reflex, the test itself smooth and easy, and the extraction was barely noticable, the video actually looks much worse than it felt.
im getting this tomorrow 😞 i dont like things up my nose at all 😞 😭 i already had an endoscopy but now in order to have surgery i have to have the nasal thing and gut test
You're welcome!
I have had both of these tests when I was younger. They hurt and I gagged and it was very hard for me to breathe. I had a hard time with many of the parts of these tests and there were times when I thought I was going to die. It was very hard because, for the 24-hour period, I had to document everything I did and what I ate and drank, If I burped or coughed, etc I had to document that. I had a moment where in the middle of the night when I felt like I had breathed in the probe into my lungs. I have had this test done twice and NEVER Want it again. It would be nice if they could create a different way to do these tests? If the first part of the test was designed where you would place your head into a headgear that would go around your head face and neck. There would be a strip that would be laid over your neck below your chin that would cover your chest and area up to your lower bowels. This item would be like taking an in-motion MRI or a fancy X-RAY where the machine would watch how everything was working. You would have a straw where different types of liquid would come through the straw into your mouth and you would drink them as the machine would tack actual video and use sound waves or some other wave to measure the muscles. Then they would have you swallow many different types of food from things such as applesauce and up to more solid items. You would fast for a good few hours before the test so you would have an empty stomach and hopefully your upper bowl or small intestine would be empty so you could see new food enter it and to see if your stomach is emptying. This test would be done in real-time. You would lay down on a special bed that has this equipment on it and the bed would sit you up and lay you down as needed for the test. This same machine would watch how you eat and chew food not only how you swallow and how your stomach is breaking the food down. Ir would measure how tight and or how loose your muscles are squeezing etc. There have to be newer ways to do these tests and more advanced ways to get more than one test in one shot and find out if the acid reflux is being caused by GP or you're through. Along with these two tests I had an upper GI where they had to put me asleep.
I had this done and it was the worst experience ever...I couldn't finish the test it hurt my throat so bad. I couldn't stop swallowing and every timd I did it felt like someone was stabbing my esophogus.
This is on tap foo me tomorrow, the last step before I qualify for Linx implant. I hope it is as easy as you made it look because I am an emetophobe! The mere thought of puking is horrific to me!!!
did you ever get the linx?
oh i dont know how to get my head around to do this, i have avoided 2 appoitments and yesterday i was about to again but i went and i pulled it out once i was gonna swallow, and i started cryin in panic. I just cant handle it, its not that i think i will die, its the feeling of someone choking me. I am afraid how i will adjust once its further down to. Vomiting for 4 years for reflux, and im up in the night being so stressed abut how to fix this for the next appoitment i now need to make :(((((
Wasn't bad at all. The worst part was that catheter pushing up against the back of my throat. It made me swallow like crazy. Took a few for me to get the swallowing under control. Oh, and that nasty nasal numbing gel. I only had to swallow saline. Did not have to swallow the thick jello like liquid. Just saline. Kudos to the two hot nurses (one giving me the saline to swallow and the one working the equipment that was pulling the readings). Catheter came out easy.
Has this done today and could make it through the placement of the probe I was gaging and choking and couldn't breath then I started throwing up it was awful. She only had me to small sips of water so I wonder if that's what the issue was
good job thnks a lot
Thanks You Sir! I have my appointment on coming monday. Even i have a anxiety issue and i am worried about my Throat Larynx while insert the tube. If its hurt? Is pain is there in Nose and Larynx after Test?
I had an endoscopy and now have been scheduled for this procedure next week. I'm 60 and pretty healthy, but had an eating disorder (hard core bulimia) for 13 years, and I have been a social smoker on and off for just as long. My own doing, but this test scares the shit out of me. Any wisdom?😢
Hi - Great video … I have a question regarding performing the manometry prior to the 24-hour ambulatory test - (1) is it possible to use an X-ray to determine its catheters placement [like when determining placement for an NG tube] (2) how does the results of the manometry help determine the distance and location of LES
thanks
Hi - Great questions! I'll answer them in reverse order, if that's OK. 1) The manometry test will reveal the location of the LES to your technician almost immediately by the pressures it exerts on the probe. The LES behaves very distinctly in relation to the rest of the esophagus, largely remaining closed most of the time (under "normal" circumstances), but relaxes shortly after you initiate a swallow. Even an abnormally behaving LES will provide a band of pressure consistently at one level, thereby revealing it's location relative to the point of entry - your nostril. THEREFORE...
2) While it would be possible to determine the placement of the 24-hour probe with an x-ray, a good technician won't need one. When placing the 24-hour acid measuring probe, the technician will use the measurements obtained during the manometry probe as a guide, but will also be watching the measured pH during placement. I ALWAYS overshoot the manometry's LES measurement and take note of the pH. If I see a very acidic measurement I can infer that I've reached the stomach and am therefore not curled up somewhere in the esophagus. Then, I'll withdraw the probe to 5cm above the manometry-revealed LES measurement, and then confirm my placement by checking the pH level again. The acid measurements should be much closer to neutral, which would reveal that I'm no longer in the stomach and have placed my probe just above the LES.
WHEW!
Hope that helps. Good luck and God bless!
P.S. It's vitally important to check the placement of an NG tube with an x-ray because you absolutely need to make sure you've got it in the right tube - meaning the esophagus not the trachea. Imagine the horror of starting a tube feeding straight into someone's lungs. YIKES! Mercifully, we don't pump any fluids through our probes. Additionally, EM/pH patients are usually wide awake and will notify us IMMEDIATELY if we're in the wrong pipe with violent coughing fits. Even if, for some odd reason, the patient didn't start coughing, the pressures/pH measurements would demonstrate that we were in the wrong place. That's probably WAY TMI. :-)
Hi, I have a question, I recently had this done and it was incredibly painful, every time I would swallow it hurt like hell, and afterwards my throat still hurt when I swallow and my reflux has gone through the roof, lots of belching and more acid than before and I’m just wondering why it seems like it shouldn’t hurt at all yet mine was so painful Idk how I managed to get through, if something went wrong and if so what happened? Thankyou
I have to get this done next week I tried a month ago and I failed miserably I was throwing up and gagging everywhere if you have any advice on how I can get through this I would greatly appreciate it I have been suffering and can’t eat for six months now and just need some answers
no thank you..I would prefer to be put asleep.. i would have already had panic attacks
Dear Gina,
Unfortunately, one should be awake for this test, since the patient should swallow
They wont even put me to sleep amd i have panic attacks . Im getting mine tomorrow . im just gunna deal with it
@@amandiablack9155 how did it go?
@@luvpieee it was the worst most excruciating pinch i have ever delt with . it was way bigger than the video 😭 i got to have my surgery after though so its worth the pain
Jesus he took that like a champ. They kept hitting the back of my throat. One she cleared it I couldn't stop gaging untill she got into place. Then I had to hold back a sneeze.
Tq for the video
It looked like an EGJ outflow obstruction according to cc v3.0
Thanks for sharing. God bless you and yours in Jesus name.
That's certainly your prerogative to not have the test done. The patient is ALWAYS the boss. If you find your symptoms are manageable, there may not a compelling reason to submit to the test.
HOWEVER, if you could find out the root cause of your symptoms and discover a way to treat them after 10-15 minutes of discomfort and thus live with lessened (or no) symptoms, wouldn't that be worth it? Of course, there are no guarantees, but it's something to consider.
Best of luck!
mzee75 when u put your tongue to your teeth to prevent swallowing do u put your tongue on the front to of your teeth or the back of your teeth? i. going in for this procedure today in 2 hrs I'm so nervous. I have bad bad gag reflux
Wow, what a public service this video is! Going in for these two procedures next month. If you had to pay for this eye candy [as in free], one would have gotten their money's worth. Only concern is that it's going on seven [7] years of aging; hope that is not significant and TYVM.
Excellent explanation! What are the chances of getting nauseous during this test? Also, can the test be stopped very quickly in the middle if the patient desires for any reason? (In other words, if the patient wants the tube out within a few seconds due to nausea or gag reflex getting out of control, is a competent nurse able and willing to comply?)
Hi there! If this test makes people uncomfortable in any one way, it can tickle the gag reflex, and for some people that can be significant. If your facility offers numbing spray, take it even though it still tastes terrible (even after all these years). Also, you have a not-so-secret weapon: breathing. Focused breathing can suppress your gag reflex. Sometimes one has to "get in the zone" mentally where all they're thinking about is "in-and-out-and-in-and-out", but if you can keep that air moving in and out, your body will keep the gag on the back burner until you're all done. Works like magic and I don't know why! This can be a bigger challenge for some than for others. It's a very individual experience. In answer to your last question, yes, the probe can be removed very quickly and safely if the test is too distressing. You may find your caregiver to be persistent as they know how beneficial this test can be. However, they shouldn't be in the torture business and be willing to pull the probe out if you insist. Best of luck and many blessings!
You can yank it out yourself if you need to. Don’t let the nurse bully you.
i had this examination today. Got numbing cream for the nose but no numbing spray for the throat. The passing through the nose was difficult for the doctor (i have a tight nose), but ok for me, it feels just uncomfortable but easy to bear. But then the part came where i had to tuck my chin in and swallow water to guide the tube down in my esophagus. At that point, the feeling i got from the tube was intolerable. It felt like someone stuffed my throat with a towel or a bar. I was saying "stop it, that feels awful" and started to make weird noises. then my gag reflex kicked in and i choked the tube out. I will never ever do this again. i asked the doctor if a lot of patients aren't able to do the test. He said that he does this since 2 years and i'm only the second person who couldn't complete the examination. Its hard for me to believe it, because that was the worst medical procedure ever to me. Good news for all of those who are scheduled for the manometry: Doctors don't push you to do it. So my experience was, that when they tried it and they saw, that it was terribly uncomfortable for me, they stopped. They were not trying to push me to do it anyways. They said that if I'm suffering like that, it doesn't make any sense to continue.Obviously the test doesn't feel too bad for some people. So i think its a good thing to just try the procedure, and look, if you can tolerate or not. If you can't take it, throw the tube out of your throat. This is quite easy and goes quickly: i just needed to choke once and out it was. I will now discuss with my doctor other options to diagnose my condition and to receive treatment (i want surgery). My history: I have since 8 years (i was 16 then), globus sensation. It feels like a constant pressure on the throat which is an awful feeling and very depressing. Doctors always suspect a psychological disease, so i was talked into psychological treatment, which didn't help at all with my symptom. I know that its not of psychological origin. my psyche is healthy.
This sounds like my situation. I was and felt close to choking during the whole thing and they weren't even able to get it down my oesophagus. But this is also the only examination I can do to know if I got achalasia since the other examinations didn't help. Good luck for you as well. If for my part suffer from a serious swallowing disorder since 7 months and am unable to eat anything but yoghurt and the like (not even puree or apple puree.) Was in hospital for 7 days, but got send home cause they think it's a mental issue, which it's not since they confirmed stuff gets stuck and it was also visible during the x-ray, sadly. So yeah, the best for us. I'm only 24 and suddenly got those issues out of the blue :'(
I feel your situation! would be interesting to chat further (lea.naoomi@gmail.com)
@@Chizuru94 hows your situation going ? I'm 26 and have had trouble swallowing for a year now. It started with heart palpitations, followed by difficulty swallowing. I had a barium swallowing test and the results were fine. So now my GI wants me to have the esophagus motility study and the 24 hour pH test.
Hello! I facing the same issue with my Throat from 2 years and Doctor suggest me Manometry test but i am not ready for this. Even most of people saying that you have psychological disease. But i know its not that issue. Is your issue is solved ? How are you feeling now? What you did for your problem? Please share... Thank You...
Lynn -- Hello how are you? I have to have the Esophagela Manometry and the 24 hour PH Study done tomorrow. I am so nervous that I am hyperventilating. Your video helped alittle but not much. I am still scared.... I have prayed about it.. So I will be okay..
Jane Doe how was it? I go for the esophageal manometry in 2 hrs. I'm scared
l Butler How was yours?
why is it important not to swallow in between? is it dangerous if you do?
Hi Vincent. It's not dangerous to swallow early, it simply does not allow the esophagus to run through its entire process, thus can make the test results inaccurate.