What is High Resolution Oesophageal and Pharyngeal Manometry (HREM, HRPM)?

High Resolution Oesophageal Manometry is a diagnostic procedure designed to measure the pressures generated in the length of your food tube from the pharynx down to the oesophagus, at rest and during swallowing.

Under local anaesthetic, a relatively fine catheter is inserted into your nose and passed down the back of your throat (pharynx), past your voice box (larynx), and into your food tube (oesophagus). The catheters have a number of specialised sensors which measure pressures generated along the length of your food tube. In general terms, pressures can be normal, too high, or too low.

This catheter is connected to a sophisticated micro-processor and computer which then visually displays in real-time the pressure changes along the length of your upper digestive tract.

The test usually takes approximately 30 minutes, and you usually have to fast 4 hours for solids and 2 hours for liquids prior to this test. You can drive yourself home afterwards, and return to work the same day.

High Resolution Pharyngeal Manometry is a relatively new assessment designed to evaluate the swallowing pressures generated in your pharynx when propelling food from your moth down towards your oesophagus during a swallow. In this case, the catheter inserted through your nose also has a number of pressure sensors sitting in the pharynx (upper throat) to measure the soft palate, base of tongue, pharynx and opening to the oesophagus (UES). We have pharyngeal manometry available for both assessment and biofeedback swallowing therapy. Your community speech pathologist, if you have one, is also encouraged to attend.