Children with suspected severe motility problems of any part of the digestive tract may require manometry or motility testing. This test is much less common and is only performed if there is a serious problem with dysmotility. It is not available at many children’s hospitals, and is typically only performed at specialized motility centers.
Separate manometry tests are available for the esophagus, stomach/duodenum, colon, and anus/rectum, all of which detect pressure within the GI tract to determine how appropriate a child’s motility is. Manometry tests are used to measure the strength, frequency, and coordination of contractions throughout the GI tract. They can help to diagnose disorders ranging from dysphagia to intestinal dysmotility or chronic constipation.
Esophageal manometry uses a catheter threaded through the nose to evaluate the motility of the esophagus. Children are asked to swallow liquids with the catheter in place. This test is commonly done together with fluoroscopy, like a video swallow study.
Antroduodenal manometry also uses a catheter through the nose or a G-tube to measure the contractions within the stomach and duodenum. Children are often sedated during the placement of the catheter. Once placed, the child remains in bed for several hours while the contractions in the lower stomach and upper part of the small intestine are recorded. In some cases, medications that affect motility may be administered to see if motility changes.
Colonic manometry is used to measure contractions within the colon. The catheter is placed through the rectum using a colonoscopy or by a radiologist. Children may be sedated during placement. The catheter remains in place for several hours to monitor activity within the colon.
Anorectal manometry tracks the function of the rectum and anus. A catheter with a balloon on the end is inserted into the rectum and the balloon is inflated to mimic stool. The response of the rectum and particularly the anus is noted during the exam.
One Parent’s Experience: We had to submit his whole chart for review and then they “accepted” him for the testing. We met with the motility specialist in office the day before the test and he discussed all the details of my son’s presentation and how the test would work. The test is done using manometry. Essentially it is a long tube with sensors that measures the muscle movements. In our case, the tubing was placed from the stoma to 40cm into the intestines. The test took between 8 and 9 hours. My son had 8 sensors from his stomach to the intestines. It looked like a big EKG on the screen.
The first part of the test is fasting. It is a lot of sitting around and waiting and keeping your child occupied–you can’t pick him up and he needs to stay pretty stationary because manometry reads muscle movement. You have to try to keep him from crying because that also messes up the readings. During the tests they trialed different medications to see the impact on the muscles. We also fed our child during the test to see the impact of food. It took several weeks to get results.