Oesophageal motility testing and 24-hour reflux studies

Abstract High-resolution manometry (HRM) and 24-hour pH/impedance studies of the oesophagus have become more widely available and are a useful tool for investigating symptoms, leading to better decision-making and ultimately improved outcomes. Advances in technology have made analysis more intuitive, and efforts have been made to better classify motility disorders and reflux exposure. However, pitfalls remain for the novice, and care is needed that the correct diagnosis is made before being applied to clinical management. Current areas of focus include improved incorporation of challenge swallows in HRM and the best way to treat borderline measurements in 24-hour reflux studies.