Esophageal Manometry
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I want to say right off, that I am not writing this to scare anyone at all. I am writing my personal experience and would like to share that so that in case others have this test, they may be better prepared. Everyone may experience this differently. This is informational.
I had lap band placed back in Nov 2011, started having problems with reflux in November 2014. I went to my surgeon and he ordered an upper GI and esophageal manometry to rule out slip, or prolapse and to figure out why my food kept coming back up. I even had food that would come up 3 days later!!!!
The reason for an esophageal manometry is to show how bad the reflux is and they also measure pressure and esophageal function. And considering my reflux was bad, this was information needed for my surgeon to document a problem. I wanted the band removed.
Upper GI was no problem, you drink some barium and they take pictures while you are drinking, which was pretty cool to see those blurbs of barium sliding down to your stomach in real time. However it showed severe reflux into my thoracic inlet which was pretty bad. In other words, it was going straight back up my esophagus mid chest.
I then went for my manometry (not the same day). This manometry test is performed by an RN. I am an RN and questioned the nurse before the procedure a ton of questions. She told me that she went to special school for about 2 weeks. Her and her fellow students, practiced this procedure on each other. She said she had done over 500 manometry ' and had been doing these for 8 years. She was the only RN that actually performed this procedure in a well know hospital system consisting of 5 large hospitals in the Saint Louis area.(which I won't mention because I work for that system.) I could have refused this test but I needed documentation. I had my BFF come with me and so glad she did.
The procedure goes like this: first she had me sit in this chair in 90 degrees, and she explained what she was going to do several times before she did anything. She sprayed my throat with a numbing agent and then my nose. She took this long tube resembling an NG tube (nasogastric tube), but this tube had these black rounded resembled flat balls (sensors), not sure how many of them were on there but there were a lot. She then started placing the tube down my nose and kept telling me to swallow sips of Water which helps get the tube down. I felt every one of these sensors. I have a bad gag reflex. It was easier said than done. She had to stop often because after about 20 seconds it became painful and I was crying. Finally after the tube was down which probably took about 10 minutes...I had a box of Kleenex on my lap and my BFF was wiping away my tears. The RN proceeded to feed me liquids 12 swallows, then applesauce 12 swallows, then Jello 12 swallows. Every swallow that I took, she was measuring pressures within my esophagus. I cried with every swallow. It was painful and I even asked her to add a little bit more of the throat spray ,but all she said was " let's just get this done". That was really inappropriate. This test is supposed to take about 25 minutes from what she told me, however 47 minutes later I finally was done. I could have stopped the test and refused any more torture but I needed this documentation. I needed to know if that band was causing these problems. I cried for 47 minutes. It was probably the worst test I have ever experienced and will never have one of those again. I actually have a new found respect for my patients with NG tubes. Another physician actually reads these pressures and then a report goes to the surgeon. In the end, the lap band overall had caused me to have induced vomiting and caused esophageal dilation causing extreme heartburn and reflux. Yes, the band was helpful and I lost 80 pounds, but I am glad to finally have relief due to recent removal 8/10/2015. I no longer have heartburn or reflux and was able to drink a small glass of orange juice for the first time in 4 years without any problems. Yay!!
When I went to my new surgeon and initially wanted a sleeve, he was going to have me do that test again to determine if I still had reflux issues after band removal!!! No way!!! I told him my awful experience and he said he could do EGD and another upper GI instead. However, for people who are bands before sleeves, he said sleeving after banding would make reflux worse. After my removal, we discussed options again and he recommended bypass. I am choosing that route because I can't go through the horrible daily non stop heartburn again. Plans for bypass in late October/early November.
So, if your surgeon orders this, there is probably good reason, and the information that this test provides may give you answers and may help diagnose a problem. Make sure you research and gather all info needed. Some people may tolerate this test better than I did. I hope that others have a better experience.