Send to

Choose Destination
Ann N Y Acad Sci. 2018 Dec;1434(1):239-253. doi: 10.1111/nyas.13709. Epub 2018 May 12.

Indications and interpretation of esophageal function testing.

Author information

Department of Medicine, Division of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri.
Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
Department of Medicine, Division of Gastroenterology, Stanford University, San Francisco, California.
Division of Gastroenterology, Department of Surgical, Oncological and Gastroenterological Sciences, University of Padua, Padua, Italy.
Division of Surgery, Department of Surgery, University of Campania - Luigi Vanvitelli, Caserta, Italy.
Université de Lyon, Hospices Civils de Lyon, Digestive Physiology, Hopital E Herriot, Lyon, France.
Université de Lyon, Lyon I University, Digestive Physiology, Lyon, France.
Université de Lyon, Inserm U1032, LabTAU, Lyon, France.


Esophageal symptoms are common, and can arise from mucosal, motor, functional, and neoplastic processes, among others. Judicious use of diagnostic testing can help define the etiology of symptoms and can direct management. Endoscopy, esophageal high-resolution manometry (HRM), ambulatory pH or pH-impedance manometry, and barium radiography are commonly used for esophageal function testing; functional lumen imaging probe is an emerging option. Recent consensus guidelines have provided direction in using test findings toward defining mechanisms of esophageal symptoms. The Chicago Classification describes hierarchical steps in diagnosing esophageal motility disorders. The Lyon Consensus characterizes conclusive evidence on esophageal testing for a diagnosis of gastroesophageal reflux disease (GERD), and establishes a motor classification of GERD. Taking these recent advances into consideration, our discussion focuses primarily on the indications, technique, equipment, and interpretation of esophageal HRM and ambulatory reflux monitoring in the evaluation of esophageal symptoms, and describes indications for alternative esophageal tests.


ambulatory pH monitoring; barium radiography; functional lumen imaging probe; high-resolution manometry; pH-impedance monitoring


Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center