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Lessons learned from physician-performed high-resolution esophageal manometries.

Nicha Wongjarupong1,2, Ali Rezaie1, Mark Pimentel1

  • 1Karsh Division of Gastroenterology and Hepatology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus
|November 8, 2025
PubMed
Summary

Physician-performed high-resolution esophageal manometry (HRM) enhances diagnostic accuracy and patient experience. This approach offers unique clinical insights and improves procedural efficiency for esophageal motility disorder diagnosis.

Keywords:
Chicago Classificationachalasiadysphagiaesophageal manometryesophageal motility disordershiatal hernia

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Area of Science:

  • Gastroenterology
  • Digestive System Physiology
  • Medical Diagnostics

Background:

  • High-resolution esophageal manometry (HRM) is crucial for diagnosing esophageal motility disorders.
  • The Chicago Classification standardizes HRM interpretation but lacks guidance on performance techniques.
  • Current practice often involves nurses or technicians, with limited physician involvement in test execution.

Purpose of the Study:

  • To provide step-by-step guidance on performing high-quality HRM, focusing on physician-led techniques.
  • To share insights and benefits derived from over two decades of physician-performed HRM experience.
  • To highlight how direct physician involvement can improve diagnostic accuracy and patient care.

Main Methods:

  • Detailed description of tips and techniques for physician-performed HRM.
  • Presentation of a practical, step-by-step approach to conducting HRM.
  • Reflections on the practical advantages observed in a clinical setting.

Main Results:

  • Physician involvement offers unique clinical insights, potentially enhancing diagnostic accuracy.
  • Direct physician performance can lead to improved procedural efficiency and better patient tolerance.
  • Continuous continuity of care and real-time interpretation are key benefits.

Conclusions:

  • Physician-performed HRM provides significant advantages over standard practice.
  • This approach optimizes diagnostic yield and enhances the overall patient experience.
  • Implementing physician-led HRM can elevate the standard of care for esophageal motility disorders.