Endoscopic aspects in diagnosis of gastroesophageal reflux disease and motility disorders: Bravo, capsule, and functional lumen imaging probe

Catheter-based testing remains the current standard of practice for the diagnosis of gastroesophageal reflux disease and esophageal motility abnormalities. Ambulatory pH testing and esophageal manometry have been in use for the past 40 years, but with the development of high-resolution manometry and multichannel intraluminal impedance testing, catheter-based testing has undergone significant recent technological improvement. Nonetheless, these tests continue to have limitations. In the case of ambulatory reflux testing, patient discomfort and limited activity remain significant problems. For esophageal manometry, methodological issues limit its ability to evaluate the function of the esophagogastric junction in normal and diseased states. In recent years, several new diagnostic tools have been developed to address the shortcomings of catheter-based testing. The wireless pH probe has been available for clinical use for more than 10 years, is better tolerated than catheter-based testing, and provides longer monitoring periods. Esophageal capsule endoscopy has undergone clinical evaluation for gastroesophageal reflux disease and Barrett esophagus with mixed results. Functional lumen imaging probe testing is a new technology that is still undergoing clinical evaluation but holds promise as a complimentary method for evaluating esophageal physiology, in particular esophagogastric junction function. © 2014 Elsevier Inc.

Duke Scholars

Author Richard Kevin Wood Jr. Medicine, Gastroenterology