High-resolution manometry changes our views of gastrointestinal motility.

High-resolution manometry using catheters with 36 solid-state sensors spaced 1 cm apart has already become an established technique for esophageal manometry where it has replaced water-perfused and station pull-through manometry. Spatiotemporal plots with color coding of pressure have greatly facilitated the analysis of esophageal peristalsis. Although suitable for the length of the esophagus, the solid-state catheter is insufficient for the study of longer segments of the gastrointestinal tract. A new technique with fiber-optic sensors has made it possible to construct catheters with 72-144 sensors. Studies of colonic motility have revealed that the most common motor pattern of the colon is a peristaltic contraction that travels 7-10 cm in the retrograde direction. Earlier studies using low-resolution manometry with 7-45 cm between sensors led us to erroneous conclusions regarding direction and frequency of contractions and they largely missed both antegrade and retrograde contractions traveling short distances. Fiber-optic high-resolution manometry holds promise for greatly improving our understanding of gut motor physiology and hopefully also our understanding of patients with symptoms of disordered gut motility.