Abstract
Esophageal impedance monitoring and high-resolution manometry (HRM) are useful tools in the diagnostic work-up of patients with upper gastrointestinal complaints. Impedance monitoring increases the diagnostic yield for gastroesophageal reflux disease in adults and children and has become the gold standard in the diagnostic work-up of reflux symptoms. Its role in the work-up for belching disorders and rumination seems promising. HRM is superior to other diagnostic tools for the evaluation of achalasia and contributes to a more specific classification of esophageal disorders in patients with non-obstructive dysphagia. The role of HRM in patients with dysphagia after laparoscopic placement of an adjustable gastric band seems promising. Future studies will further determine the clinical implications of the new insights which have been acquired with these techniques. This review aims to describe the clinical applications of impedance monitoring and HRM.
Highlights
Esophageal manometry is being performed in humans since the early 1950s [1]
Esophageal pressure topography was adopted for the presentation of high-resolution manometry (HRM) data [3] (Fig. 1a)
This review aims to describe the clinical applications of esophageal impedance monitoring and HRM
Summary
Esophageal manometry is being performed in humans since the early 1950s [1]. Since esophageal manometry has greatly increased our understanding of esophageal function and is currently a widely performed technique to assess esophageal function. Conventional manometry assemblies detect pressure using a catheter with several water-perfused sideholes and with or without the addition of a, so called, sleeve sensor or solid state pressure transducers [2]. Conventional manometry catheters are limited by gaps between the pressure sensors which are several centimeters long. Esophageal pressure topography was adopted for the presentation of HRM data [3] (Fig. 1a). This technique assigns color to specific pressure levels which are than presented in a spatiotemporal plot. These pressure topography plots are more intuitive and easier learned by clinicians [4]
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