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Related Experiment Video

Updated: Oct 17, 2025

Quantification of Levator Ani Hiatus Enlargement by Magnetic Resonance Imaging in Males and Females with Pelvic Organ Prolapse

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Imperfect high-resolution manometry studies: Prevalence and predictive factors.

Tricia Hengehold¹, Benjamin Rogers^1,2, C Prakash Gyawali¹

¹Division of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri, USA.

Neurogastroenterology and Motility

|October 12, 2021

Summary

Imperfect high-resolution manometry (HRM) studies are rare, especially when performed by trained operators. Achalasia is linked to curled catheters, while large hiatus hernias correlate with non-critically imperfect studies.

Keywords:

achalasia hiatus hernia high-resolution manometry

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A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology

A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology

Published on: February 7, 2015

Area of Science:

Gastroenterology
Esophageal Physiology
Medical Device Technology

Background:

Imperfect esophageal high-resolution manometry (HRM) studies can complicate patient management.
Ensuring the quality of HRM studies is crucial for accurate diagnosis of esophageal motility disorders.

Purpose of the Study:

To determine the prevalence and predictors of imperfect esophageal high-resolution manometry (HRM) studies.
To assess the impact of operator training and patient factors on HRM study quality.

Main Methods:

Retrospective analysis of 962 esophageal high-resolution manometry (HRM) studies performed by trained operators over two years.
Categorization of imperfect studies as critically imperfect (LES not traversed) or non-critically imperfect (diaphragm not traversed).
Recording reasons for imperfect studies and real-time identification by motility nurses versus physician review.

Main Results:

3.4% of HRM studies were critically imperfect, and 13.0% were non-critically imperfect.
Achalasia was associated with critically imperfect studies (curled catheters), while large hiatus hernias were linked to non-critically imperfect studies.
Motility nurses identified 90.9% of critically imperfect studies in real-time.

Conclusions:

Critically imperfect HRM studies are rare with trained operators and are often identified and aborted in real-time.
Achalasia should be suspected with curled catheters, particularly in older patients.
Intolerant patients undergoing HRM may not have critical motor disorders.