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Review
. 2012 Jun;14(3):197-205.
doi: 10.1007/s11894-012-0253-9.

Clinical applications of esophageal impedance monitoring and high-resolution manometry

Boudewijn F Kessing  1 , André J P M Smout, Albert J Bredenoord
Affiliations
Review

Clinical applications of esophageal impedance monitoring and high-resolution manometry

Boudewijn F Kessing et al. Curr Gastroenterol Rep. 2012 Jun.

Abstract

Esophageal impedance monitoring and high-resolution manometry (HRM) are useful tools in the diagnostic work-up of patients with upper gastrointestinal complaints. Impedance monitoring increases the diagnostic yield for gastroesophageal reflux disease in adults and children and has become the gold standard in the diagnostic work-up of reflux symptoms. Its role in the work-up for belching disorders and rumination seems promising. HRM is superior to other diagnostic tools for the evaluation of achalasia and contributes to a more specific classification of esophageal disorders in patients with non-obstructive dysphagia. The role of HRM in patients with dysphagia after laparoscopic placement of an adjustable gastric band seems promising. Future studies will further determine the clinical implications of the new insights which have been acquired with these techniques. This review aims to describe the clinical applications of impedance monitoring and HRM.

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Figures

Fig. 1
Fig. 1
HRM plots of the esophagus. a Anatomical landmarks which can be identified with the use of HRM. b Assessment of LES relaxation using the integrated relaxation pressure (IRP). c Identification of peristaltic landmarks using the 20-mmHg and 30-mmHg isobaric contour lines. d Assessment of peristaltic function
Fig. 2
Fig. 2
Impedance tracings of a wet swallow and a liquid reflux episode. Wet swallows are characterized by an antegrade drop in impedance channels whereas a reflux episode is characterized by a retrograde drop in impedance channels after which a swallows clears the refluxate and the impedance levels return to their respective baseline level
See this image and copyright information in PMC

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