Esophageal testing: What we have so far

Abstract

Gastroesophageal reflux disease (GERD) is a common disorder of the gastrointestinal tract. In the last few decades, new technologies have evolved and have been applied to the functional study of the esophagus, allowing for the improvement of our knowledge of the pathophysiology of GERD. High-resolution manometry (HRM) permits greater understanding of the function of the esophagogastric junction and the risks associated with hiatal hernia. Moreover, HRM has been found to be more reproducible and sensitive than conventional water-perfused manometry to detect the presence of transient lower esophageal sphincter relaxation. Esophageal 24-h pH-metry with or without combined impedance is usually performed in patients with negative endoscopy and reflux symptoms who have a poor response to anti-reflux medical therapy to assess esophageal acid exposure and symptom-reflux correlations. In particular, esophageal 24-h impedance and pH monitoring can detect acid and non-acid reflux events. EndoFLIP is a recent technique poorly applied in clinical practice, although it provides a large amount of information about the esophagogastric junction. In the coming years, laryngopharyngeal symptoms could be evaluated with up and coming non-invasive or minimally invasive techniques, such as pepsin detection in saliva or pharyngeal pH-metry.

Complications with Fiberoptic Endoscopic Evaluation of Swallowing in 2,820 Examinations

“…Other tests that are considered complementary for studying dysphagia are oro-pharyngo-oesophageal scintigraphy [17,18,19], ultrasound [20,21,22,23], pH manometry [24,25,26,27] and, most recently, high-resolution manometry [27,28,29,30]. All the instrumental tests used for assessing dysphagia have advantages, disadvantages and side effects.…”

MULTICHANNEL INTRALUMINAL IMPEDANCE AND pH

“…Furthermore, it is an utmost tool to identify non-acid reflux events associated with typical and atypical symptoms as is the case in chronic cough investigation (8) . It seems that nonacid reflux does not appear to be directly related to the development of esophageal mucosa lesions; however, it is definitely involved in the genesis of symptoms in both NERD and erosive esophagitis patients (1) .…”

Beer effects on postprandial digestive symptoms and gastroesophagic physiology

“…Gastroesophageal reflux was evaluated by esophageal impedance‐pH monitoring, which allows for acid and non‐acid reflux episodes to be recorded over a 24‐hour period . For this purpose, we used a disposable catheter (Versaflex ® Z; Given Imaging, Yokne’am Illit, Israel), consisting of 6 impedance monitoring channels (located at 3, 5, 7, 9, 15 and 17 cm from the distal end) and 1 pH channel (located at 5 cm from the distal end).…”

“…Gastroesophageal reflux was evaluated by esophageal impedance-pH monitoring, which allows for acid and non-acid reflux episodes to be recorded over a 24-hour period. 13 For this purpose, we used a disposable catheter (Versaflex ® Z; Given Imaging, Yokne'am Illit, Israel), consisting of 6 impedance monitoring channels (located at 3, 5, 7, 9, 15 and 17 cm from the distal end) and 1 pH channel (located at 5 cm from the distal end). Catheter placement was achieved by inserting it nasally until a reading of pH <4 was obtained, and then gradually withdrawing it until the reading changed to an esophageal pH (pH 6-7.5), deemed to be the gastroesophageal transition point.…”