Abstract
Multichannel intraluminal impedance (MII) is an evolving technique for the evaluation of gastroesophageal reflux disease (GERD) and of nonacid reflux in patients with persistent typical or atypical GERD symptoms refractory to acid suppression therapy. Similar to barium swallow, it can assess esophageal bolus transit, but without the hazards of radiation exposure. MII is frequently used in combination with pH monitoring to detect esophageal exposure to gastroduodenal content. This combination detects all types of reflux, the pH of the reflux, and the proximal extent of a reflux event. MII can be used in combination with esophageal manometry to allow concurrent assessment of esophageal function (bolus transit) and motility. Thus, it provides a more complete esophageal function test than esophageal manometry alone. The few limitations of impedance monitoring include the complexity of the interpretation of the tracings and the paucity of data in diseased populations. However, recent developments over the past 2 years have overcome these limitations, improving the detection of GERD and the evaluation of various esophageal function abnormalities.
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