High resolution manometry represents an interesting technological advance, facilitating the procedure, a continuous recording of the peristalsis on a single image, a user-friendly reading of the spatio-temporal relationship of the peristaltic waves, and the identification of suspended focal abnormalities. Telemetric pH-metry, performed by insertion of a wireless capsule directly in the oesophagus, now remplaces conventional pH-metry, which requires a naso-oesophageal line. The main acquisition in 2008 is, however, the advent of oesophageal pH-impedancemetry. This test permits to establish a time relation between the patient's symptoms and reflux episodes, acidic as well as pH-neutral ones. This novel technic is useful for patients that remain symptomatic despite anti-secretory therapy, for patients with atypical symptoms and for those with extra-digestive symptoms.