Novel GERD Treatment Concept

Esophageal Function Test & Reflux Monitoring

Esophageal Manometry

Manometry aims to assess the profile of the esophagogastric junction (EGJ) pressure zone (the lower esophageal sphincter; LES) and the transport function of the body of the esophagus.

Modern combination of high resolution manometry and esophageal impedance enables simultaneous assessment of pressure events and transport of a bolus through the esophagus (combined high resolution / impedance manometry). Presence of complete or incomplete bolus transit through the esophagus can be adequately assessed. This information is of major importance for the planing of anti reflux surgery (see there). In addition, manometry aims to exclude non GERD related disease (i.e. achalasia)

NOTE: In GERD both the EGJ-pressure zone and the transport function are impaired. Do NOT conduct fundoplication WITHOUT esophageal manometry and reflux monitoring.

Figure 6: High resolution manometry of a person with GERD symptoms. LES: lower esophageal sphincter. Yellow arrow marks swallow induced relaxation of the LES.
Figure 7: Combined high resolution manometry and intraluminal impedance in a person with dysphagia. Note the absence of peristalsis and relaxation of the LES: lower esophageal sphincter. Intraluminal impedance shows absence of bolus transport along the esophagus. The diagnosis is achalasia. Image by Sandhill technology.