HREM: What You Need To Know

If you have been diagnosed with a swallowing disorder, such as dysphagia, achalasia, or gastroesophageal reflux disease (GERD), your doctor may recommend a test called high-resolution esophageal manometry (HREM). 

This test measures the pressure and movement of your esophagus, the muscular tube that connects your mouth to your stomach. HREM can help identify the cause of your swallowing problems and guide the best treatment options.

Here is a bit of information about HREM to help you better understand it.

What Is HREM and How Does It Work?

HREM is a non-invasive procedure that involves inserting a thin, flexible tube through your nose and into your esophagus. The tube has sensors that record the pressure and coordination of your esophageal muscles as you swallow small amounts of water. The test is usually done in an outpatient clinic. You may feel some discomfort or gagging during the test, but it is not painful.

The results of HREM are displayed on a computer screen as a color-coded map of your esophageal function. The map shows how well your esophagus contracts and relaxes, and how well it propels food and liquids to your stomach. Your doctor will interpret the map and look for any abnormalities that may explain your symptoms.

What Are the Benefits of HREM?

HREM is a more accurate and comprehensive way of assessing your esophageal function than conventional manometry, which uses fewer sensors and produces less detailed results. HREM can detect subtle changes in your esophageal pressure and movement that may be missed by other tests, such as X-rays or endoscopy. The procedure can also help diagnose rare or complex swallowing disorders that may not have a clear cause.

The test can help your doctor determine the best treatment for your condition, whether it is medication, surgery, or other therapies. For example, HREM can help identify candidates for peroral endoscopic myotomy (POEM), a minimally invasive procedure that cuts the muscle fibers of the lower esophageal sphincter to relieve symptoms of achalasia. HREM can also help monitor the effectiveness of your treatment over time.

How Can You Prepare for HREM?

Before the test, you will need to fast for several hours to ensure that your stomach and esophagus are empty. You will also need to stop taking certain medications that may affect your esophageal function, such as antacids, calcium channel blockers, or nitrates. Your doctor will give you specific instructions on what medications to avoid and when to resume them after the test.

To learn more about high-resolution esophageal manometry support, schedule a consultation with a physician in your local area.