If you are doing a bravo PH test where they attach the Sensor to the lower part of your esphogus then you dont do a manomerty. That PH test is useless. If your are doing a dual sensor ph test where the put tube through your nose and into your stomach then yes you need a manometry to figure out sensor placement. Yes there are GI doctors who dont do manomertys but the tests are flawed.

I had 2 ph tests and 4 manomertys done. I would rather have a tube in my mouth for 15 mins then for 24 hours. PH test is pure hell.

Many GI and ENT's dont want to do them. I think its because they dont know how to interpret them. The ones who do have equipment dont have High Def ones so the test is more torture as its a pull through system. Test takes 25-30 mins instead of 10 mins.I am not knocking the ph test all I am saying is your show know your motility and LES pressure to start with. Obviously, if someone has LES pressure less the 10hg's then need PPI's. If that doesnt work, you need surgery. There is ofcourse the poor folks who are refluxing Bile (non acid) and are waiting for a drug to supress both.