Manometric evaluation of esophageal disease

Esophageal manometry has been helpful in delineating several aspects of the pathophysiology of esophageal disease. Its immediate contribution to patient care, however, is not clear. We reviewed our experience with 59 consecutive patients who had been referred to our laboratory specifically for this study. Manometry provided new information resulting in better patient management in only eight patients (14%). Manometric abnormalities are uncommon when radiographs and endoscopy are normal; thus, manometry should rarely be used alone to evaluate subjective complaints. It is useful preoperatively in patients with reflux esophagitis if a motility disorder is suspected and in patients with cricopharyngeal abnormality. After hiatal hernia repair performed with an adequate preoperative radiologic and endoscopic evaluation for reflux esophagitis, esophageal manometry contributes little additional information to the evaluation of postoperative dysphagia.