HOW TO TREAT 21
ausdoc. com. au 22 AUGUST 2025
HOW TO TREAT 21
Figure 1. Normal barium swallow. Figure 2. Normal manometry during swallowing. international consensus classification for the diagnosis of oesophageal motility disorders and provides a standardised approach for interpretation of results and diagnosis. 19
The advantage of performing manometry is that it is minimally invasive and no sedation is required. It is, however, a highly specialised test and only available in select major hospitals. 15
Adapted from Kuo P et al 2012 15
OTHER OESOPHAGEAL TESTS GORD is highly prevalent and commonly associated with oesophageal hypomotility and dysphagia. An oesophageal pH test, performed in conjunction with manometry, is indicated in those with either suspected or established pathological reflux when no other cause for dysphagia has been identified. This test uses either a transnasal pH catheter with / without impedance monitoring or a wireless pH capsule attached endoscopically to the distal oesophagus.
Successful treatment of reflux disease can often result in resolution of dysphagia, independent of underlying oesophageal motility, as the symptom is potentially a sensory disorder related to the increased acid exposure. 20
When there is uncertainty regarding the clinical significance of a benign oesophageal stricture or motility disorders, such as achalasia or oesophagogastric outlet obstruction, impedance planimetry can be used to further assess the distensibility of the stricture or even dilate the stricture in select cases. Impedance
Figure 3. Proposed approach to the initial investigation and management of dysphagia.