title: Esophageal testing: What we have so far.
abstract: Gastroesophageal reflux disease (GERD) is a common disorder of the gastrointestinal tract. In the last few decades, new technologies have evolved and have been applied to the functional study of the esophagus, allowing for the improvement of our knowledge of the pathophysiology of GERD. High-resolution manometry (HRM) permits greater understanding of the function of the esophagogastric junction and the risks associated with hiatal hernia. Moreover, HRM has been found to be more reproducible and sensitive than conventional water-perfused manometry to detect the presence of transient lower esophageal sphincter relaxation. Esophageal 24-h pH-metry with or without combined impedance is usually performed in patients with negative endoscopy and reflux symptoms who have a poor response to anti-reflux medical therapy to assess esophageal acid exposure and symptom-reflux correlations. In particular, esophageal 24-h impedance and pH monitoring can detect acid and non-acid reflux events. EndoFLIP is a recent technique poorly applied in clinical practice, although it provides a large amount of information about the esophagogastric junction. In the coming years, laryngopharyngeal symptoms could be evaluated with up and coming non-invasive or minimally invasive techniques, such as pepsin detection in saliva or pharyngeal pH-metry. Future studies are required of these techniques to evaluate their diagnostic accuracy and usefulness, although the available data are promising.
authors.affiliation: Nicola de Bortoli, Irene Martinucci, Lorenzo Bertani, Salvatore Russo, Riccardo Franchi, Valeria Bolognesi, Massimo Bellini, Santino Marchi, Gastroenterology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 54124 Pisa, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: de Bortoli
authors.affiliation: Nicola de Bortoli, Irene Martinucci, Lorenzo Bertani, Salvatore Russo, Riccardo Franchi, Valeria Bolognesi, Massimo Bellini, Santino Marchi, Gastroenterology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 54124 Pisa, Italy.
authors.forename: Irene
authors.initials: I
authors.lastname: Martinucci
authors.affiliation: Nicola de Bortoli, Irene Martinucci, Lorenzo Bertani, Salvatore Russo, Riccardo Franchi, Valeria Bolognesi, Massimo Bellini, Santino Marchi, Gastroenterology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 54124 Pisa, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Bertani
authors.affiliation: Nicola de Bortoli, Irene Martinucci, Lorenzo Bertani, Salvatore Russo, Riccardo Franchi, Valeria Bolognesi, Massimo Bellini, Santino Marchi, Gastroenterology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 54124 Pisa, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Russo
authors.affiliation: Nicola de Bortoli, Irene Martinucci, Lorenzo Bertani, Salvatore Russo, Riccardo Franchi, Valeria Bolognesi, Massimo Bellini, Santino Marchi, Gastroenterology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 54124 Pisa, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Franchi
authors.affiliation: Nicola de Bortoli, Irene Martinucci, Lorenzo Bertani, Salvatore Russo, Riccardo Franchi, Valeria Bolognesi, Massimo Bellini, Santino Marchi, Gastroenterology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 54124 Pisa, Italy.
authors.forename: Manuele
authors.initials: M
authors.lastname: Furnari
authors.affiliation: Nicola de Bortoli, Irene Martinucci, Lorenzo Bertani, Salvatore Russo, Riccardo Franchi, Valeria Bolognesi, Massimo Bellini, Santino Marchi, Gastroenterology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 54124 Pisa, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Tolone
authors.affiliation: Nicola de Bortoli, Irene Martinucci, Lorenzo Bertani, Salvatore Russo, Riccardo Franchi, Valeria Bolognesi, Massimo Bellini, Santino Marchi, Gastroenterology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 54124 Pisa, Italy.
authors.forename: Giorgia
authors.initials: G
authors.lastname: Bodini
authors.affiliation: Nicola de Bortoli, Irene Martinucci, Lorenzo Bertani, Salvatore Russo, Riccardo Franchi, Valeria Bolognesi, Massimo Bellini, Santino Marchi, Gastroenterology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 54124 Pisa, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Bolognesi
authors.affiliation: Nicola de Bortoli, Irene Martinucci, Lorenzo Bertani, Salvatore Russo, Riccardo Franchi, Valeria Bolognesi, Massimo Bellini, Santino Marchi, Gastroenterology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 54124 Pisa, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Bellini
authors.affiliation: Nicola de Bortoli, Irene Martinucci, Lorenzo Bertani, Salvatore Russo, Riccardo Franchi, Valeria Bolognesi, Massimo Bellini, Santino Marchi, Gastroenterology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 54124 Pisa, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Savarino
authors.affiliation: Nicola de Bortoli, Irene Martinucci, Lorenzo Bertani, Salvatore Russo, Riccardo Franchi, Valeria Bolognesi, Massimo Bellini, Santino Marchi, Gastroenterology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 54124 Pisa, Italy.
authors.forename: Santino
authors.initials: S
authors.lastname: Marchi
authors.affiliation: Nicola de Bortoli, Irene Martinucci, Lorenzo Bertani, Salvatore Russo, Riccardo Franchi, Valeria Bolognesi, Massimo Bellini, Santino Marchi, Gastroenterology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 54124 Pisa, Italy.
authors.forename: Edoardo Vincenzo
authors.initials: EV
authors.lastname: Savarino
keywords: BRAVO; EndoFLIP; Gastroesophageal reflux disease; High resolution manometry; Multichannel impedance and pH; PEP-test; Restech