Esophageal Motility Testing: Impedance-Based Transit Measurement and High-Resolution Manometry

Esophageal function tests are widely used, not only to obtain insight into esophageal physiology and pathophysiology in a research setting, but also to diagnose esophageal motor disorders in patients with symptoms such as dysphagia and chest pain. While esophageal function testing has long been considered almost synonymous with manometry, recently new techniques such as impedance measurement and high-resolution manometry have emerged. With impedance monitoring the transit of a bolus through the esophagus can be studied without the use of ionizing radiation. High-resolution manometry offers a highly detailed and comprehensive view of esophageal pressure patterns. Multichannel high resolution manometry with color plotting facilitates positioning of the catheter and interpretation of the tracings. In this article the development, clinical usefulness, and indications of these new tests are discussed.