Clinical use of manometry for the diagnosis of intestinal motor abnormalities

Digestive symptoms suggestive of intestinal motor disorders, such as abdomi nal pain and distension, fullness, vomiting, constipation and diarrhoea, ar e very common and non-specific, and may be clinical manifestations of both organic and functional diseases. Both radiology and endoscopy are important in the diagnosis of structural gastrointestinal lesions that can affect mo tility and offer indirect signs of impaired gastrointestinal functions, but the diagnosis of gut motility disorders currently relies on the manometric assessment of contractile activities. Small bowel manometry helps to ident ify normal motility features and consequently to identify abnormal motor pa tterns. Small bowel manometry can help to differentiate mechanical obstruct ion from pseudo-obstruction and neurogenic from myogenic motor disorders. M anometry is an invasive technique which is not well accepted by patients an d requires specific skills from investigators. Also, manometric assessment is limited to referral centres with a specific interest in the field of dig estive functions, in general, and motility, in particular. Only patients wh o remain undiagnosed after extensive traditional work-up and fail repeated courses with medical therapy should be referred for the manometric test. Un derstanding the underlying pathophysiologic mechanisms of abnormal motility and developing new therapies are the goals of the current research in this fascinating field of medicine.