High resolution manometry in esophageal disorders
Agata Ladić, Alemka Jaklin-Kekez, Nadan Rustemović1,, Željko Krznarić
Esophageal manometry is one of the main axes in diagnostic armamentarium that deals with esophageal motility disorders, next to endoscopic and radiological methods. Traditional, conventional manometry, has greatly been replaced by a modern technique, high resolution manometry which enables not only better spatiotemporal signal resolution and compatibility, but also shortens the time of the procedure which is extremely important for patients undergoing it. Two catheters are being used, solid state and water perfused. Both record pressures within the esophageal lumen and both esophageal sphincters. Contemporary technology has also enabled incorporation of impedance sensors into the catheter. Impedance is based on resistance changes to liquid or food boluses.These changes help in bolus transit evaluation, reducing the need for ionization procedures. Each examined bolus (liquid or solid) is evaluated according to Chicago classification criteria and parameters that are within these criteria. According to the third version of the Classification, functional esophageal disorders are divided into EGJ outflow obstruction disorders, major peristaltic and minor peristaltic disorders. Introduction of this methodology, but also the continuous update of Chicago classification, help in timely diagnosis and further treatment of all the more frequently diagnosed functional esophageal disorders.