When would your physician order an esophageal manometry?

Motility problems. If your physician suspects motility problems, or abnormal movement of the esophagus or associated sphincters, then manometry, or pressure measurements may be ordered. Syndromes include hiatal hernia, achalasia, esophageal spasm and zenker's and epihrenic diverticulum.
Swallowing/GERD. Esophageal manometry may be used to help diagnose difficult swallowing problems. Basically, it measures pressures in different parts of the esophagus as you swallow and can differentiate different types of issues. It is used as part of the workup in gerd for patients being considered for anti-reflux surgery.