Clinical Use of Esophageal Physiologic Testing

We suggest that patients with obstructive esophageal symptoms without a mechanical cause should undergo HRM for evaluation of esophageal motility disorders. (Conditional (weak) “We suggest”, Very low)

We recommend HRM over conventional line tracing manometry for the diagnosis of esophageal motility disorders in patients with obstructive esophageal symptoms. (Strong “We recommend”, Moderate)

We suggest utilization of supplementary/provocative maneuvers with the HRM protocol to improve the diagnostic yield of esophageal motility disorders in patients with obstructive esophageal symptoms. (Conditional (weak) “We suggest”, Low)

We suggest the inclusion of a barium tablet with a barium esophagram during the evaluation of obstructive esophageal symptoms. (Conditional (weak) “We suggest”, Very low)

We suggest the use of FLIP to complement HRM for the diagnosis of esophageal motility disorders in patients with obstructive esophageal symptoms and borderline HRM findings. (Conditional (weak) “We suggest”, Low)

We suggest that the EGJ and gastric cardia anatomy should be inspected endoscopically and/or radiographically to assess for mechanical abnormalities in patients with esophageal symptoms after antireflux surgery. (Conditional (weak) “We suggest”, Very low)