High-resolution manometry (HRM) as a innovative diagnostic technique is used to evaluate functional oesophageal disorders. This method has been available in Poland since 2008. High color resolution, spatiotemporal plot-pressure maps, and large number of closely-spaced pressure sensors, provide accurate interpretation of motility alternations and the functional anatomy of the oesophagogastric junction, when compared to conventional manometry. The aim of this paper is to demonstrate the wide range of the diagnostic usefulness of this method when referred to a classification of oesophageal motility disorders recently created in Chicago. HRM reveals the segmental character of oesophageal peristalsis and the functional anatomy of the oesophagogastric junction. The aim of HRM application in gastroesophageal reflux disease (GERD) is to establish the LES position, its activity and it is an accurate method in order to confirm or exclude the presence of hiatus hernia. HRM is the method of choice to indentify the early stage of achalasia, as well as for the differentiation of 3 types of achalasia (classic, vigorous and spastic). HRM introduces a new DCI (distal contractile integral) parameter that is used to distinguish peristaltic disfunctions with high amplitude and also classify four types of nutcracker oesophagus (such as: classic,segmental, spastic, and nutcracker LES). In addition, HRM is very useful for identifying the early stages of functional oesophageal alternation in scleroderma and other connective tissue diseases. Thus, HRM plays a very essential role in diagnosing functional oesophageal disorders and in choosing the proper pharmacological or surgical treatment.

Polish Surgery 2010, 12, 2, 89–102