New technology at Comanche County Memorial Hospital allows them to do tests to see whether someone’s esophagus is working correctly. Dr. Michael Sawyer, a General Surgeon at CCMH, said Esophageal Manometry lets doctors and nurses see how well the esophagus contracts and pushes food along.
“And that’s important because if you’re going to undergo any type of operation to fix a hiatal hernia or fix a reflux disease, it’s important to know that to know exactly what type of procedure to do,” he said.
Those needing the study done go to Comanche County Memorial Hospital’s GI Lab.
“What we do is we send a probe down,” said Bryan Jameson, an RN at the GI Lab. “Which is this probe here, and the probe goes down the esophagus, and it’s inserted into the right place and then what we have the patients do is swallow water or normal saline, and we watch the saline go down and the muscles contract.”
The procedure takes about twenty to thirty minutes. Jameson said the longest part is getting the probe down and making sure the patient is still relaxed.
Dr. Sawyer said manometry is good because it can detect if it’s reflux disease or a different kind of esophagus disease that presents the same types of symptoms.
“There’s one called achalasia where there is extreme tightness at the bottom of the esophagus, and manometry can frequently pick this up very well,” Dr. Sawyer said. “So, it’s important to differentiate between these types of diseases to effectively treat them, and up until recently, we haven’t had the ability to do that here. This is now greatly expanded the diagnostic capability of our gastrointestinal lab up here.”
Before, every year one to two hundred people had to drive over an hour to get the twenty to thirty-minute test done.
Along with the Esophageal Manometry test, they also have BRAVO pH monitoring.
“Back in the day, you used to have another catheter that would be threaded down your nose and attached to a recorder that would, that you’d have to carry around, and you’d have to have the catheter sticking out of your nose like a day or two days,” he said. “Now, there’s a wireless transmitter that can be placed during an upper endoscopy, down close to where the stomach and the esophagus come together, and that can measure episodes of reflux. So, we know when they happen because the pH in the esophagus drops dramatically when the acid from the stomach comes up.”
He said the patient has to keep a diary for a day instead of having something hanging out of their nose. He said within 5 to 7 days, it detaches from the esophagus and makes its way out. Dr. Sawyer said it’s important to know that reflux disease is not a totally benign thing, and medication people take to help with it wasn’t created for people to stay on for years.
“The problem with that is sometimes it can mask the symptoms by making the pH of the reflux a little bit higher,” he said. “So you don’t get the symptoms as much, but the damage is still being done.”
Dr. Sawyer believes that’s why the amount of certain esophageal cancers are on the rise. He said if you’ve been on the medicine for several years, it’s good to get an endoscopy done to make sure you don’t have some of the precursors to esophageal cancers.