Published online Feb 15, 2016. doi: 10.4291/wjgp.v7.i1.72
Peer-review started: July 12, 2015
First decision: September 22, 2015
Revised: December 2, 2015
Accepted: December 29, 2015
Article in press: January 4, 2016
Published online: February 15, 2016
Core tip: 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 gastroesophageal reflux disease. High-resolution manometry permits a greater understanding of the function of the esophagogastric junction and the risks associated with hiatal hernia. The Chicago Classification V3.0 could define a hierarchic classification that accurately defines the major and minor disorders of esophageal motility. Esophageal 24-h pH-metry, especially when it is combined with 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 are able to 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. Recently, up and coming non-invasive or minimally invasive techniques, such as pepsin detection in saliva or pharyngeal pH-metry, have been suggested to detect laryngopharyngeal reflux disease. Future studies are required for these techniques to evaluate their accuracy and usefulness, although the available data are promising.