Challenging the limits of esophageal manometry.

After steady improvement until about 1980, the technology behind esophageal manometry saw little change until recent years. A variety of sensor technologies existed including solid-state strain gauge transducers, circumferentially sensitive transducers, multilumen perfused catheters with external pressure transducers, and the Dentsleeve device. However, irrespective of transducer design, the basic format of manometric studies was of multiple line-tracings representing pressure change versus time at several discrete esophageal loci. Furthermore, of the sensor designs available, only the Dentsleeve device provided a validated method for assessing sphincter relaxation. However, the Dentsleeve accomplished this at the expense of pressure response rate and spatial resolution leading some experts to focus instead on these limitations. In brief, little standardization existed in methodology among centers and there was no agreement regarding optimal assembly design or study interpretation.