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  • Review Article
  • Published:

Advances in motility testing—current and novel approaches

Nature Reviews Gastroenterology & Hepatology volume 10, pages 463–472 (2013)Cite this article

Subjects

Abstract

Disorders of gastrointestinal motility are frequently seen in clinical practice. Apart from motility disorders, factors leading to lowered visceroperception thresholds are recognized as commonly involved in the pathogenesis of functional gastrointestinal disorders. The wide array of gastrointestinal motility and viscerosensitivity tests available is in contrast with the relatively limited number of tests used universally in clinical practice. The main reason for this discrepancy is that the outcome of a test only becomes truly important when it carries clinical consequences. The main goal of this Review is to assess the place of the presently available gastrointestinal motility and sensitivity tests in the clinical armamentarium of the gastroenterologist.

Key Points

  • High-resolution manometry makes the assessment of oesophageal function easier and provides more information than conventional manometry

  • Wireless oesophageal pH monitoring provides an opportunity to assess gastro-oesophageal reflux over prolonged periods of time in a patient-friendly fashion

  • Intraluminal impedance monitoring of the oesophagus not only enables detection of nonacid reflux, but can also distinguish different belching types

  • Wireless motility capsule technology has made it possible to study gastric emptying, small bowel transit and colonic transit in one noninvasive assessment

  • Several newly developed investigational tools (such as impedance planimetry and colonic high-resolution manometry) are promising, but their diagnostic value is not yet clear

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Figure 1: Oesophageal manometry.
Figure 2: Timed barium oesophagogram in a patient with achalasia previously treated with Heller myotomy.
Figure 3: Oesophageal impedance and pH recording.
Figure 4: Concurrent gastric transit measurement with wireless motility capsule and scintigraphy.
Figure 5: Normal and abnormal antroduodenal manometry.
Figure 6: Supine abdominal radiograph taken after ingestion of 20 radio-opaque markers 5 days previously.

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  1. Department of Gastroenterology and Hepatology, Academic Medical Center, Meibergdreef 9, Amsterdam, 1100 DE, the Netherlands

    Albert J. Bredenoord & André J. P. M. Smout

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The authors contributed equally to all aspects of this article.

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A. J. Bredenoord has received research funding from Shire–Movetis NV and Endostim and received payment from MMS International for development of educational presentations. A. J. P. M. Smout has received sponsorship from Shire–Movetis NV, MMS international and Given Imaging for an educational meeting on motility testing.

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Bredenoord, A., Smout, A. Advances in motility testing—current and novel approaches. Nat Rev Gastroenterol Hepatol 10, 463–472 (2013). https://doi.org/10.1038/nrgastro.2013.80

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