pediatric esophageal ano rectal manometry

Manometry is used to evaluate the contractile activity of the gastrointestinal (GI) tract, which has a specific motility pattern along its segments. By measuring the pressure inside the GI tract and the pattern of the phasic contractions, problems in GI tract muscles, and related nerves may be detected.

Most common method for manometry in India is the use of high-resolution manometry (HRM) by a water-perfused catheter that contains multiple capillary tubes running longitudinally within it. Pressurized water is infused through the intercapillary tubes within the catheter and the pressure change generated by the GI tract is transmitted through the capillary tubes, and back to the external transducers and recorded in a computer.

Esophageal Manometry

Indications:

• Swallowing problems – Dysphagia/ Odynophagia
• Primary motility disorder: achalasia, nutcracker esophagus and diffuse esophageal spasm,
• To check pressure of lower esophageal sphinctor
• Patients should fast for 4 to 6 hours prior to the study to decrease the risk of vomiting and aspiration. No sedation is given as child’s cooperation is needed. The manometric catheter is placed nasally.

Anorectal Manometry

• Chronic constipation
• Fecal incontinence - to assess anal sphincter function and weakness
• To evaluate postoperative patients after imperforate anus repair
• Pelvic floor dyssynergia

Before the procedure, a clearance of the distal bowel is needed. A phosphate enema is usually given before the study. There is no need for fasting in older children who doesn’t need sedation. Young children do not cooperate and are too anxious and often need mild sedation.