Esophageal Manometry

Esophageal manometry is the primary method by which esophageal motility is evaluated, indicated in the clinical settings of nonobstructive dysphagia and gastroesophageal reflux disease (particularly prior to antireflux surgery). High-resolution manometry can be interpreted via standardized classification schemes such as the Chicago Classification and the Lyon Consensus. Achalasia is the hallmark primary esophageal motor disorder, characterized by abnormal lower esophageal relaxation and absent peristalsis, which can be further classified into subtypes with prognostic and management implications. Clinical heterogeneity among other motility classifications can provided challenges. Future advances, such as integration of impedance and provocative swallows, may help improve characterization of esophageal motility.