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How to Effectively Use High-Resolution Esophageal Manometry.

Esophageal manometry is the definitive test to evaluate esophageal motility and is indicated in the diagnostic evaluation of patients with nonobstructive dysphagia. Esophageal manometry is also indicated in the preoperative evaluation of patients from foregut surgery (Heller myotomy, Nissen fundoplication), which can be associated with significant morbidity, are often based on HRM studies. These are high-impact, often difficult, decisions and high-quality studies optimize patient outcomes. Additionally, manometry requires transnasal intubation, which is uncomfortable and can make patients very averse to repeat procedures, so it is incumbent on those making the first attempt to do it properly. When done properly, an HRM study is like a radiograph that can be put on a memory stick or CD and sent to an expert for a second opinion if necessary. However, faxed (black and white) copies of computergenerated automated interpretations or faxed Clouse plots