Esophageal manometry is a direct method to detect esophageal motor function. It is combined with gastroscopy/barium meal, etc. for a complete assessment of esophageal function. Q1: When is esophageal manometry needed? If you have symptoms such as chest pain, acid reflux, belching, difficulty swallowing or eating, regurgitation or nausea and vomiting, esophageal manometry can be performed after gastroscopy to rule out neoplastic lesions. Some extra-esophageal symptoms such as dry cough, asthma, hoarseness, nasal itching, and ear pain are also required for esophageal manometry when considered to be of esophageal origin. Q2: How do I perform esophageal manometry? When you want to have an esophageal manometry, you should fast from 10:00 p.m. the day before the test until the end of the test. You should also stop taking related therapeutic drugs such as nitroglycerin, calcium channel blockers, prokinetic agents, proton pump inhibitors, pain relievers, etc. 48 hours before the test. The examination should be performed for 15-30 minutes. Q3: What conditions can present abnormal esophageal manometry results? (1) Primary esophageal dysmotic diseases, i.e. diseases caused by abnormal esophageal motility due to structural or functional changes in the esophagus itself: gastroesophageal reflux (GERD), achalasia of the cardia, nutcracker esophagus, diffuse esophageal spasm, LES hypertension, etc. (2) Secondary esophageal dysmotility disorders, i.e., esophageal motility disorders caused by lesions in other organs or systems: scleroderma, dermatomyositis, diabetic esophagus, central and peripheral neuropathy involving esophageal motility, idiopathic pseudo-small bowel obstruction, etc. Esophageal manometry helps to determine the prognosis and differential diagnosis of the primary condition. (3) Non-specific esophageal motility disorders. Many patients have abnormal esophageal pressure patterns but do not strictly meet the diagnostic criteria for primary esophageal motility disorders, so they are classified as non-specific esophageal motility disorders (NEMD). Esophageal manometry is the gold standard for esophageal motility testing and is important for guiding medication, endoscopic treatment, efficacy evaluation and prognostic assessment.