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The Utility of Esophageal Motility Testing in Gastroesophageal Reflux Disease (GERD).

Publication ,  Journal Article
Garbarino, S; Horton, A; Patel, A
Published in: Curr Gastroenterol Rep
July 10, 2019

PURPOSE OF REVIEW: Here, we discuss how esophageal motor testing plays important roles in patients with suspected gastroesophageal reflux disease (GERD). In addition to guiding appropriate placement of catheters for ambulatory reflux monitoring, esophageal high-resolution manometry (HRM) rules out confounding diagnoses, such as achalasia spectrum disorders, that can present with symptoms similar to that of GERD, but are managed very differently. RECENT FINDINGS: HRM performed with impedance in the post-prandial setting (PP-HRIM) can assess for rumination syndrome or supragastric belching, which should be directed towards behavioral interventions. The recent GERD Classification of Motor Function recommends a hierarchical approach, focusing on (1) the esophagogastric junction (EGJ), (2) the esophageal body, and (3) esophageal contraction reserve, which can be assessed with provocative maneuvers at HRM, such as multiple rapid swallows (MRS). This approach can inform the appropriate tailoring of antireflux surgery. Novel esophageal motility metrics, such as the EGJ-contractile integral from HRM, or post-reflux swallow-induced peristaltic wave indices from 24-h pH-impedance monitoring, may also assist with GERD diagnosis. Assessment of esophageal motor function can contribute in a significant manner to the care of patients with suspected GERD, particularly when esophageal symptoms do not improve with antisecretory therapy, and/or when surgical or endoscopic antireflux therapies are under consideration.

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Published In

Curr Gastroenterol Rep

DOI

EISSN

1534-312X

Publication Date

July 10, 2019

Volume

21

Issue

8

Start / End Page

37

Location

United States

Related Subject Headings

  • Rumination Syndrome
  • Peristalsis
  • Monitoring, Ambulatory
  • Manometry
  • Humans
  • Gastroesophageal Reflux
  • Gastroenterology & Hepatology
  • Esophagus
  • Esophagogastric Junction
  • Esophageal Achalasia
 

Citation

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ICMJE
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Garbarino, S., Horton, A., & Patel, A. (2019). The Utility of Esophageal Motility Testing in Gastroesophageal Reflux Disease (GERD). Curr Gastroenterol Rep, 21(8), 37. https://doi.org/10.1007/s11894-019-0704-7
Garbarino, Stephanie, Anthony Horton, and Amit Patel. “The Utility of Esophageal Motility Testing in Gastroesophageal Reflux Disease (GERD).Curr Gastroenterol Rep 21, no. 8 (July 10, 2019): 37. https://doi.org/10.1007/s11894-019-0704-7.
Garbarino S, Horton A, Patel A. The Utility of Esophageal Motility Testing in Gastroesophageal Reflux Disease (GERD). Curr Gastroenterol Rep. 2019 Jul 10;21(8):37.
Garbarino, Stephanie, et al. “The Utility of Esophageal Motility Testing in Gastroesophageal Reflux Disease (GERD).Curr Gastroenterol Rep, vol. 21, no. 8, July 2019, p. 37. Pubmed, doi:10.1007/s11894-019-0704-7.
Garbarino S, Horton A, Patel A. The Utility of Esophageal Motility Testing in Gastroesophageal Reflux Disease (GERD). Curr Gastroenterol Rep. 2019 Jul 10;21(8):37.
Journal cover image

Published In

Curr Gastroenterol Rep

DOI

EISSN

1534-312X

Publication Date

July 10, 2019

Volume

21

Issue

8

Start / End Page

37

Location

United States

Related Subject Headings

  • Rumination Syndrome
  • Peristalsis
  • Monitoring, Ambulatory
  • Manometry
  • Humans
  • Gastroesophageal Reflux
  • Gastroenterology & Hepatology
  • Esophagus
  • Esophagogastric Junction
  • Esophageal Achalasia