Future perspectives in esophageal manometry

doi:10.4240/wjgs.v17.i12.113546

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Dec 27, 2025 (publication date) through Dec 25, 2025

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastrointest Surg. Dec 27, 2025; 17(12): 113546
Published online Dec 27, 2025. doi: 10.4240/wjgs.v17.i12.113546

Future perspectives in esophageal manometry

Stefan Lucian Popa, Vlad Dumitru Brata, Olga Hilda Orășan, Giuseppe Chiarioni, Abdulrahman Ismaiel, Alexandru Marius Padureanu, Dinu Iuliu Dumitrascu, Miruna Oana Dita, Mara Filip, Traian Adrian Duse, Raphaël Eftimie Spitz, Teodora Surdea-Blaga

Stefan Lucian Popa, Abdulrahman Ismaiel, Teodora Surdea-Blaga, Second Medical Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca 400000, Romania

Vlad Dumitru Brata, Department of Gastroenterology, Regional Institute of Gastroenterology and Hepatology "Prof. Dr. Octavian Fodor", Cluj-Napoca 400394, Cluj, Romania

Olga Hilda Orășan, Fourth Department of Internal Medicine, Faculty of Medicine, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca 400012, Cluj, Romania

Giuseppe Chiarioni, Il Cerchio Med Global Healthcare, Verona Center, Verona 37100, Italy

Alexandru Marius Padureanu, Miruna Oana Dita, Raphaël Eftimie Spitz, Department of General Medicine, Faculty of Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca 400000, Cluj, Romania

Dinu Iuliu Dumitrascu, Department of Anatomy, UMF "Iuliu Hatieganu" Cluj-Napoca, Cluj-Napoca 400000, Cluj, Romania

Mara Filip, Cluj County Emergency Clinical Hospital, Cluj County Emergency Clinical Hospital, Cluj-Napoca 400347, Cluj, Romania

Traian Adrian Duse, Department of Surgery, Regional Institute of Gastroenterology and Hepatology "Prof. Dr. Octavian Fodor", Cluj-Napoca 400394, Cluj, Romania

Author contributions: Popa SL, Brata VD, and Surdea-Blaga T contributed to the conceptual design, supervision, and critical revision of the manuscript; Orășan OH, Chiarioni G, and Ismaiel A contributed to the literature search, critical revision, manuscript editing and interpretation of the content; Padureanu AM, Dumitrascu DI, Dita MO, Filip M, Duse TA, and Eftimie Spitz R contributed to manuscript writing and editing and provided critical intellectual input.

Conflict-of-interest statement: The authors declare no conflict of interest.

Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Vlad Dumitru Brata, MD, Researcher, Department of Gastroenterology, Regional Institute of Gastroenterology and Hepatology "Prof. Dr. Octavian Fodor", Croitorilor St 19, Cluj-Napoca 400394, Cluj, Romania. brata_vlad@yahoo.com

Received: August 28, 2025
Revised: October 6, 2025
Accepted: November 11, 2025
Published online: December 27, 2025
Processing time: 119 Days and 17.3 Hours

Abstract

Esophageal manometry has undergone significant advancements, transitioning from conventional line tracings to high-resolution manometry with topographic analysis. This evolution has improved the classification and diagnosis of esophageal motility disorders, as defined by the Chicago Classification. However, challenges remain in interpreting borderline cases, assessing esophagogastric junction outflow obstruction, and correlating manometric findings with clinical symptoms. Artificial intelligence (AI) has emerged as a promising tool for enhancing esophageal manometry by enabling automated data analysis, pattern recognition, and predictive modeling. Future perspectives include the integration of AI for automated analysis, refinement of pressure topography metrics, and incorporation of adjunctive testing such as functional luminal imaging probe technology. Additionally, novel catheter designs and ambulatory manometry may enhance diagnostic accuracy and patient comfort. Integrating manometry findings with biomechanical models and machine learning techniques may support the development of more personalized management strategies. This review explores current and emerging technologies and their potential impact on the future of esophageal manometry, aiming to improve diagnostic precision and therapeutic outcomes in esophageal motility disorders.

Keywords: Esophageal manometry; High-resolution manometry; Motility disorders; Artificial intelligence; Translational challenges

Core Tip: Esophageal manometry continues to evolve beyond conventional techniques, with high-resolution manometry, adjunctive tools such as functional luminal imaging probe, and emerging artificial intelligence (AI) applications, paving the way for more precise, automated, and clinically meaningful assessments. This review highlights how integrating advanced metrics, novel technologies, and AI may overcome current diagnostic limitations and contribute to a more personalized management of esophageal motility disorders.