Utility of Ambulatory Esophageal pH and High-Resolution Manometry in the Diagnosis of Gastro-Esophageal Reflux Disease and Hiatal Hernia



The esophago-gastric junction (EGJ) allows esophageal clearance and venting of air (belching) while, at the same time, restricting gastroesophageal reflux. Pathology or disruption of the EGJ can impair the passage of food and fluid from the esophagus into the stomach or increase the risk of gastroesophageal reflux disease (GERD). In this article, we review the structure and function of the EGJ in health and disease. The contribution of esophageal high-resolution manometry (HRM) and ambulatory pH-impedance monitoring to GERD diagnosis is considered. Throughout there is an emphasis on how the results of investigation in patients with suspected GERD impacts on management. Additionally, the role of physiological investigation in patients with esophageal symptoms after anti-reflux surgery is considered.


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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Department of GastroenterologyChangi General HospitalSingaporeSingapore
  2. 2.Department of Gastroenterology, Abdominal CenterSt. ClaraspitalBaselSwitzerland
  3. 3.Neurogastroenterology and Motility Research Group, Department of Gastroenterology and HepatologyUniversity Hospital ZürichZürichSwitzerland

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