Traditionally we used to measure the LES generated pressure, either during resting or at swallowing, by means of water perfused catheter or solid state sensors. With modern High Resolution Manometry, the LES generated pressures are measured in several points few mm apart. The function of LES is inferred by calculating its pressure and the length on whom this pressure is exerted and how it alters after swallowing.
Two articles in the current issue of Diseases of the Esophagus deal with a new tool (Endoflip) that allows to calculate the force needed to open the LES (LES distensibility). In the first, A. Ilczyszyn, K. Hamaoui, J. Cartwright and A. Botha, discuss the clinical utility of these measurements to optimize the myotomy in achalasia patients (Intraoperative distensibility measurement during laparoscopic Heller's myotomy for achalasia may reduce the myotomy length without compromising patient outcome, pages 455–462) and in the second, C. Lottrup, B. P. McMahon, P. Ejstrud, M. A. Ostapiuk, P. Funch-Jensen and A. M. Drewes present their finding on LES distensibility in a group of Hiatus hernia, Barretts and control patients. (Esophagogastric junction distensibility in hiatus hernia, pages 463–471) .
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