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Esophageal pH monitoring is performed for 24 or 48 hours and at the end of recording, a patient's tracing is analyzed and the results are expressed using six standard components. Of these 6 parameters, a pH score called Composite pH Score or DeMeester Score has been calculated, which is a global measure of esophageal acid exposure.
The diagnosis is made by an esophageal motility study (esophageal manometry), which evaluates the pressure of the esophagus at various points along its length. The term "nutcracker esophagus" comes from the finding of increased pressures during peristalsis , with a diagnosis made when pressures exceed 180 mmHg; this has been likened to the ...
An esophageal motility study (EMS) or esophageal manometry is a test to assess motor function of the upper esophageal sphincter (UES), esophageal body and lower esophageal sphincter (LES). [ 1 ] Indications
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Esophageal manometry is not recommended for use in the diagnosis, being recommended only prior to surgery. [42] Ambulatory esophageal pH monitoring may be useful in those who do not improve after PPIs and is not needed in those in whom Barrett's esophagus is seen. [42] Investigation for H. pylori is not usually needed. [42]
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The diagnosis is generally confirmed by esophageal manometry. [2] DES is present when more than a fifth of swallows results in distal esophageal contractions. [2] NE is present if the average strength of the contractions of the distal esophagus is greater than 180 mmHg but the contraction of the esophagus is otherwise normal. [2]