Esophageal Manometry

  • Jeffrey L. Conklin
  • Joseph A. Murray


The major functions of the esophagus and its sphincters are to transport from the pharynx to the stomach what is swallowed, to prevent the reflux of gastric contents into the esophagus and airways, and to clear the esophagus of gastroesophageal refluxate. Carrying out these tasks requires the precise integration of a bewildering array of neuromuscular processes in the central nervous system, the myenteric plexus, and the muscular components of the esophagus. Esophageal manometry gives the clinician insight into the function of these neuromuscular processes, and in some cases allows the diagnosis of specific abnormalities of esophageal motor function.


Lower Esophageal Sphincter Esophageal Manometry Lower Esophageal Sphincter Relaxation Peristaltic Contraction Diffuse Esophageal Spasm 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Conklin JL, Christensen J. Motor Functions of the Pharynx and Esophagus. In: Physiology of the Gastrointestinal Tract, L.R. Johnson (Ed.), Raven Press, New York, NY, pp. 903–928, 1994.Google Scholar
  2. 2.
    Miller A, Bieger MD, Conklin JL. Functional Controls of Deglutition. In: Deglutition and its Disorders: Anatomy, Physiology, Clinical Diagnosis and Management, A. Perlman, K. Schulze-Delrieu (Eds.), Singular Publishing Group, Inc., San Diego, CA, pp. 43–97, 1996.Google Scholar
  3. 3.
    Dodds WJ, Steff JJ, Hogan WI. Factors determining pressure measurement accuracy by intraluminal esophageal manometry. Gastroenterology 70: 117–123, 1976.PubMedGoogle Scholar
  4. 4.
    Arndorfer RC, Steff JJ, Dodds WJ, Linehan JH, Hogan. WJ. Improved infusion system for intraluminal esophageal manometry. Gastroenterology 73: 23–27, 1977.PubMedGoogle Scholar
  5. 5.
    Kahrilas PJ, Dodds WJ, Dent J, Logeman JA, Shaker R. Upper esophageal sphincter function during deglutition. Gastroenterology 95: 52–62, 1988.PubMedGoogle Scholar
  6. 6.
    Dodds WJ, Stewart ET, Hodges D, Zboralske FF. Movement of the feline esophagus associated with respiration and peristalsis. J Clin Invest 52:1–13,1973.PubMedCrossRefGoogle Scholar
  7. 7.
    Edmundowicz S, Clouse RE. Shortening of the esophagus in response to swallowing. Am J Physiol 260: G512–516,1991.PubMedGoogle Scholar
  8. 8.
    Dent J. A new technique fror continuous sphincter pressure measurement. Gastroenterology 71:263–267, 1976.PubMedGoogle Scholar
  9. 9.
    Linehan JH, Dent J, Dodds WJ, Hogan WJ. Sleeve devise functions as a Starling resistor to record sphincter pressure. Am J Physiol 248:G251–G256, 1985.PubMedGoogle Scholar
  10. 10.
    Richter JE, Wu WC, Johns DN, Blackwell JN, Nelson JL, Castel! JA, Castel! DO. Esophageal manometry in 95 health adult volunteers. Dig Dis Sci 32:583–592, 1987.PubMedCrossRefGoogle Scholar
  11. 11.
    Dodds WJ, Hogan WJ, Reed DP, Stewart ET, Arndorfer RC. A comparison between primary peristalsis following wet and dry swallows. J Appl Physiol 35:851–857, 1973.PubMedGoogle Scholar
  12. 12.
    All GN, Wallace KL, Laundi TM, Hunt DR, DeCarle DJ, Cook IJ. Predictions of outcomes following cricopharyngeal disruption for pharyngeal dysphagia. Dysphagia 12:133–139, 1997.CrossRefGoogle Scholar
  13. 13.
    Hewson EG, Ott DJ, Dalton CB, Chen YM, Wu WC, Richter JE. Manometry and radiology, complimentary studies in the assessment of esophageal motility disorders. Gastroenterology 98: 626–632, 1990.PubMedGoogle Scholar
  14. 14.
    Kahrilas PJ, Dodds WJ, Hogan WJ, Kern M, Arndorfer RC, Reece A. Peristaltic dysfunction in peptic esophagitis. Gastroenterology 91: 897–904, 1986.PubMedGoogle Scholar
  15. 15.
    Kahrilas PJ, Dodds WJ, Hogan WJ. The effect of peristaltic dysfunction on esophageal volume clearance. Gastroenterology 94:73–80, 1988.PubMedGoogle Scholar
  16. 16.
    Clouse RE, Staiani A. Contraction abnormalities of the esophageal body in patients referred for manometry; a new approach to classification. Dig Dis Sci 28: 784–791, 1983.PubMedCrossRefGoogle Scholar
  17. 17.
    Clouse RE, Staiani A, Landau DW, Schlachter JL. Manometric findings during spontaneous chest pain in patients with presumed esophageal “spasms.” Gastroenterology 85: 395–402, 1983.PubMedGoogle Scholar
  18. 18.
    Kahrilas PJ, Hogan WJ, Clouse RE. American Gastroenterological Association technical review on the clinical use of esophageal manometry. Gastroenterology 107: 1865–1884, 1994.PubMedCrossRefGoogle Scholar
  19. 19.
    Benjamin SB, Richter JE, Cordova CM, Knuff TE, Castell DO. Prospective manometric evaluation with pharmacological provocation of patients with esophageal motility dysfunction. Gastroenterology 84: 893–901, 1983.PubMedGoogle Scholar
  20. 20.
    Katz PO, Dalton CB, Richter JE, Wu WC, Castell DO. Esophageal testing of patients with noncardiac chest pain or dysphagia. Ann Intern Med 106: 593–597, 1987.PubMedGoogle Scholar
  21. 21.
    Ott DJ, Richter JE, Chen YW, Wu WC, Gelfand DW, Castell DO. Esophageal radiology and manometry; correlation in 172 patients with dysphagia. Am J Roentgnol 149:307–311, 1987.Google Scholar
  22. 22.
    Massey BT, Dodds WJ, Hogan WJ, Brasseur JG, Helm, JF. Abnormal esophageal motility. An analysis of concurrent radiographic and manometric findings. Gastroenterology 101: 334–354, 1991.Google Scholar
  23. 23.
    Bancewicz J, Osugi H, Marples M. Clinical implications of abnormal esophageal motility. Brit J Surg 74: 416–419, 1987.PubMedCrossRefGoogle Scholar
  24. 24.
    Achem SR, Kolts BE, Wears R, Burton L. Richter JE. Chest pain associated with nutcracker esophagus: a preliminary study of the role of gastroesophageal relfux. Am J Gastroenterol 88: 187–192,1993.PubMedGoogle Scholar
  25. 25.
    Singh S, Price JE, Richter JE. The LES locator: accurate placement of an electrode for 24 hour pH measurement with combined solid state pressure transducer. Am J Gastroenterol 87: 967–970, 1992.PubMedGoogle Scholar
  26. 26.
    Marples MJ, Mughal M, Bancewicz J. Canand esophageal pH electrode be accurately positioned without esophageal manometry? In: Siewert JR, Holscher AH, eds. Diseases of the Esophagus. Springer-Verlag, New York, 789–791, 1987.Google Scholar
  27. 27.
    Mattox HE, Richter JE, Sinclair JW, Price JE, Case ID. The gastroesophageal pH step up inaccurately locates the proximal lower esophageal sphincter. Dig Dis Sci 37: 1185–1191, 1992.PubMedCrossRefGoogle Scholar
  28. 28.
    Joelsson BE, DeMeester TR, Skinner DB, LaFontaine E, Waters PF, O’Sullivan GC. The role of the esophageal body in the antireflux mechanism. Surgery 92: 417–424, 1982.PubMedGoogle Scholar
  29. 29.
    Spechler SJ. Department of Veterans Affairs Gastroesophageal Reflux Disease Study Group. Comparison of medical and surgical therapy for complicated gastroesophageal reflux disease. N Engl J Med 326: 786–792,1992.PubMedCrossRefGoogle Scholar
  30. 30.
    Mughal MM, Bancewicz J, Marples M. Esophageal manometry and pH recording does not predict the bad results of Nissen fundoplacation. Br J Surg 77: 43–43, 1990.PubMedCrossRefGoogle Scholar
  31. 31.
    Escandell AO, Martinez de Haro LF, Paricio PP, Albasani JLA, Marcilla JAG, Cuenca GM. Surgery improves defective oesophageal peristalsis in patients with gastro-oesophageal reflux. Br J Surg 78:1095–1097, 1991.CrossRefGoogle Scholar
  32. 32.
    Stevens, MB, Hookman P, Siegel CI, Esterly JR, Shulman LE, Hendrix TR. Aperistalsis of the esophagus in patient with connective-tissue disorders and Raynaud’s phenomenon. N Engl J Med 270: 1218–1222, 1964.PubMedCrossRefGoogle Scholar
  33. 33.
    Cohen S, Harris LD. Does hiatus hernia affect competence of the gastroesophageal sphincter? N Engl J Med 284: 1053–1056,1971.PubMedCrossRefGoogle Scholar
  34. 34.
    Dodds WJ, Dent J, Hogan WJ, Helm, JF, Hauser R, Patel GK, Egide MS. Mechanisms of gastroesophageal reflux in patients with reflux esophagitis. N Engl J Med 301:1547–1552, 1982.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1999

Authors and Affiliations

  • Jeffrey L. Conklin
    • 1
  • Joseph A. Murray
    • 1
    • 2
  1. 1.Department of Internal Medicine, College of MedicineUniversity of Iowa and Iowa City VA Medical CenterIowa CityUSA
  2. 2.Mayo ClinicRochesterUSA

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