Esophageal manometry in gastroesophageal reflux disease

Gastroenterol Clin North Am. 2014 Mar;43(1):69-87. doi: 10.1016/j.gtc.2013.11.005. Epub 2013 Dec 28.

Abstract

High-resolution manometry (HRM) allows nuanced evaluation of esophageal motor function, and more accurate evaluation of lower esophageal sphincter (LES) function, in comparison with conventional manometry. Pathophysiologic correlates of gastroesophageal reflux disease (GERD) and esophageal peristaltic performance are well addressed by this technique. HRM may alter the surgical decision by assessment of esophageal peristaltic function and exclusion of esophageal outflow obstruction before antireflux surgery. Provocative testing during HRM may assess esophageal smooth muscle peristaltic reserve and help predict the likelihood of transit symptoms following antireflux surgery. HRM represents a continuously evolving new technology that compliments the evaluation and management of GERD.

Keywords: Esophageal hypomotility; High-resolution manometry; Hypotensive lower esophageal sphincter; Multiple rapid swallows; Preoperative testing.

Publication types

  • Review

MeSH terms

  • Esophageal Sphincter, Lower / physiopathology
  • Fundoplication
  • Gastroesophageal Reflux / physiopathology*
  • Gastroesophageal Reflux / surgery
  • Humans
  • Manometry / methods*
  • Peristalsis / physiology
  • Preoperative Care