Review article: oesophageal function testing - the old and the new

Gastro-oesophageal reflux disease can manifest typically with heartburn and regurgitation and atypically with extra-oesophageal symptoms, such as chest pain, worsening asthma, chronic cough or laryngitis. Although acid-suppressive therapy can help identify individuals in whom gastro-oesophageal reflux disease is the cause of their symptoms, diagnostic testing is often needed to evaluate those with persistent symptoms. Recent advances in oesophageal diagnostic testing include the advent of a wireless pH-monitoring device that eliminates the need for a transnasal catheter as well as an ambulatory impedance monitoring device that allows measurement of weakly acidic or non-acidic refluxate. The advantages and disadvantages as well as clinical utility of these new, as well as traditional, oesophageal-measuring devices are discussed in this review.