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Current Treatment Options in Gastroenterology

27-03-2024 | Achalasia

FLIP in Clinical Practice: When Is It Helpful?

Authors: Elena C. Pezzino, MD, Daniel R. Arndorfer, MD, Dustin A. Carlson, MD, MSCI

Published in: Current Treatment Options in Gastroenterology

Abstract

Purpose of Review

Functional lumen imaging probe (FLIP) Panometry is as an important tool in the diagnosis and management of esophageal disorders.

Recent Findings

Using high-resolution impedance planimetry, FLIP assesses esophagogastric junction (EGJ) and esophageal body distensibility as well as the contractile response to distension (secondary peristalsis) at the time of sedated endoscopy. These features can be incorporated to classify esophageal motility, which often parallels high-resolution manometry (HRM) and the Chicago Classification (CCv4.0). The role of FLIP Panometry has been evaluated in multiple clinical scenarios, such as clarifying inconclusive HRM, excluding primary esophageal motility disorders, and guiding management for esophageal diseases.

Summary

FLIP Panometry has proven to be a diagnostic tool that can complement, or in some cases be an alternative to, HRM in the evaluation of esophageal dysmotility. The strongest recommended benefit of FLIP in current clinical practice is with clarifying equivocal HRM, such as EGJOO or inconclusive achalasia. There are also promising results demonstrating the role for FLIP in excluding primary motility disorders during an initial endoscopy, as well as for the use of FLIP for evaluating treatment and outcomes in achalasia, gastroesophageal reflux disease (GERD), and eosinophilic esophagitis (EoE). With continued expanding use of FLIP across multiple centers and clinical scenarios, additional evolution of the role for FLIP is anticipated as well.

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Title: FLIP in Clinical Practice: When Is It Helpful?
Authors: Elena C. Pezzino, MD
Daniel R. Arndorfer, MD
Dustin A. Carlson, MD, MSCI
Publication date: 27-03-2024
Publisher: Springer US
Keywords: Achalasia
Eosinophilic Esophagitis
Motility Disorder
Motility Disorder
Gastroesophageal Reflux Disease
Dysphagia
Dysphagia
Dysphagia
Endoscopy
Published in: Current Treatment Options in Gastroenterology
Print ISSN: 1092-8472
Electronic ISSN: 1534-309X
DOI: https://doi.org/10.1007/s11938-024-00442-8

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