This is the current release of the guideline.

This guideline updates a previous version: An American Gastroenterological Association medical position statement on the clinical use of esophageal manometry. American Gastroenterological Association. Gastroenterology 1994 Dec;107(6):1865.

According to the guideline developer, the Clinical Practice Committee meets three times a year to review all American Gastroenterological Association Institute (AGAI) guidelines. This review includes new literature searches of electronic databases followed by expert committee review of new evidence that has emerged since the original publication date.

These recommendations are an update from previous recommendations published in 1994 and represent the results of meticulous research into areas of controversy from the previous policy statement. In addition, new techniques have evolved that may improve and complement manometric diagnosis. Thus, these recommendations also take into account how these new technologies may alter clinical practice.

Indications for Esophageal Manometry

1. Manometry is indicated to establish the diagnosis of dysphagia in instances in which a mechanical obstruction (e.g., stricture) cannot be found. This is particularly important if a diagnosis of achalasia is suspected. However, given the low prevalence of achalasia in patients with esophageal symptoms, more common esophageal disorders should be excluded with barium radiographs or endoscopy before manometric evaluation.
2. Manometric techniques are indicated for placement of intraluminal devices (e.g., pH probes) when positioning is dependent on the relationship to functional landmarks, such as the lower esophageal sphincter.
3. Manometry is indicated for the preoperative assessment of patients being considered for antireflux surgery if there is any question of an alternative diagnosis, especially achalasia.

Possible Indications for Esophageal Manometry

1. Manometry is possibly indicated for the preoperative assessment of peristaltic function in patients being considered for antireflex surgery.
2. Manometry is possibly indicated to assess symptoms of dysphagia in patients who have undergone either antireflux surgery or treatment for achalasia.

Esophageal Manometry Not Indicated

1. Manometry is not indicated for making or confirming a suspected diagnosis of gastroesophageal reflux disease.
2. Manometry should not be routinely used as the initial test for chest pain or other esophageal symptoms because of the low specificity of the findings and the low likelihood of detecting a clinically significant motility disorder.

None provided

The type of evidence supporting the recommendations is not specifically stated.

The recommendations are based upon the interpretation and assimilation of scientifically valid research, derived from a comprehensive review of published literature.

Not applicable: The guideline was not adapted from another source.

1994 Jul 15 (revised 2005 Jan)

American Gastroenterological Association Institute - Medical Specialty Society

American Gastroenterological Association Institute

American Gastroenterological Association Clinical Practice Committee

Authors: John E. Pandolfino; Peter J. Kahrilas

Not stated

This is the current release of the guideline.

This guideline updates a previous version: An American Gastroenterological Association medical position statement on the clinical use of esophageal manometry. American Gastroenterological Association. Gastroenterology 1994 Dec;107(6):1865.

According to the guideline developer, the Clinical Practice Committee meets three times a year to review all American Gastroenterological Association Institute (AGAI) guidelines. This review includes new literature searches of electronic databases followed by expert committee review of new evidence that has emerged since the original publication date.

None available

This summary was completed by ECRI on June 30, 1998. It was verified by the guideline developer on December 1, 1998. This NGC summary was updated by ECRI on January 31, 2005.

This NGC summary is based on the original guideline, which is subject to the guideline developer's copyright restrictions. Please contact the Public Policy Coordinator, American Gastroenterological Association, 4930 Del Ray Avenue, Bethesda, MD 20814; telephone, (301) 654-2055; fax, (301) 654-5970.