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.