Predictive value of routine esophageal high‐resolution manometry for gastro‐esophageal reflux disease

Abstract

Hiatal hernia, low contraction amplitude and LES pressure are associated with GERD, but do not predict the disease with sufficient accuracy. Routine esophageal HRM can therefore not be used to distinguish GERD patients from healthy subjects.

Impaired motility in Barrett's esophagus: A study using high-resolution manometry with physiologic challenge

“…Yet despite the advent of esophageal high‐resolution manometry (HRM) with its improved spatiotemporal representation of esophageal function, the majority of publications report function based on single water swallows while in the supine position. Using this methodology, studies have proposed that routine esophageal HRM cannot be used to differentiate GERD patients from healthy subjects; however, there is doubt as to whether this form of testing can act as a surrogate for normal eating and drinking behavior. The inclusion of solid swallows and free drinking while in the more physiological upright seated position using advanced HRM systems has been shown to be reproducible and accurate at detecting pathology .…”

Prolonged measurement improves the assessment of the barrier function of the esophago‐gastric junction by high‐resolution manometry

“…This is likely explained by the multifactorial etiology of GERD that includes not only impaired EGJ structure and function, but also impaired esophageal clearance function, increased intra‐abdominal pressure (e.g., obesity) and abnormal gastric function . No single HRM parameter can capture the full complexity of upper gastrointestinal function or provide an adequate description of all factors involved in GERD pathophysiology . For example, it is known that transient LES relaxations (TLESR) are an important mechanism mediating gastro‐esophageal reflux .…”

Novel insights into esophageal diagnostic procedures

“…The gold standard for the evaluation of esophageal motility, HREM, has a growing role in the evaluation of GERD . Recently, Van Hoeij et al . tried to verify whether routine HREM had a predictive value for the presence of GERD .…”