High resolution manometry

Oesophageal manometry

High resolution oesophageal manometry (HREM) is used for the assessment of oesophageal motility disorders i.e. problems with the muscle contraction of the oesophagus. Abnormalities can be because of reduced or excessive contraction of the oesophageal muscles.

HREM is performed using a probe that is inserted through a nostril. The probe is positioned so that its sensors run the length of the oesophagus. The patient then performs at least 10 swallows, and these are recorded and interpreted. These readings are plotted on a three-dimensional graph:

  • Horizontal axis is time
  • Vertical axis is length along the oesophagus
  • Perpendicular axis is pressure

HREM can give much more information than traditional oesophageal manometry methods, and has led to many advances in the diagnosis and classification of oesophageal motility disorders.

Anorectal manometry
Anorectal manometry assesses anal sphincter and rectal pressure and function. This is useful in the work-up of certain patients with faecal incontinence and constipation. It can also be used in bio-feedback therapy in patients with obstructive defecation syndrome.