Clinical usefulness of esophageal high resolution manometry and adjunctive tests: An update

Area of Science:

• Gastroenterology
• Esophageal Physiology
• Diagnostic Technology

Background:

• Conventional manometry has limitations in assessing esophageal motor function.
• The Chicago Classification provides a standardized framework for interpreting esophageal motility data.
• Advancements in technology have expanded the capabilities of esophageal manometry.

Purpose of the Study:

• To highlight the evolution and expanded utility of high resolution manometry (HRM).
• To discuss the role of HRM in diagnosing and subtyping esophageal motility disorders.
• To emphasize the impact of HRM on clinical practice and patient management.

Main Methods:

• Evolution of the high resolution manometry (HRM) protocol, including supine and upright swallows, and provocative maneuvers.
• Integration of impedance with HRM for bolus clearance assessment.
• Complementary use of barium radiography and functional lumen imaging probe for esophagogastric junction obstruction evaluation.

Main Results:

• HRM significantly improves the diagnosis and subtyping of achalasia spectrum disorders.
• HRM better characterizes spastic disorders and absent contractility.
• HRM defines esophagogastric junction morphology and tone, assessing peristalsis for reflux and clearance.

Conclusions:

• High resolution manometry (HRM) has revolutionized the evaluation of esophageal motor function.
• HRM enhances the diagnosis and management of a wide range of esophageal motility disorders.
• The expanded utility of HRM has significantly impacted clinical practice in gastroenterology.