Functional Lumen Imaging Probe (EndoFLIP) in Upper Gastrointestinal Disorders: Current Evidence, Clinical Applications, and Future Perspectives

The Functional Lumen Imaging Probe (EndoFLIP®) system is an impedance-based technology providing real-time measurements of cross-sectional area (CSA) and intraballoon pressure across a luminal segment. Initially developed for esophagogastric junction (EGJ) evaluation in achalasia, the application of EndoFLIP has subsequently expanded to the assessment of both sphincteric and non-sphincteric regions throughout the gastrointestinal tract in a variety of clinical conditions, including eosinophilic esophagitis (EoE), post-fundoplication states, and gastroparesis. Its unique ability to be utilized in both the diagnostic and therapeutic settings, including the assessment of treatment response, makes it a valuable tool in the overall management of gastrointestinal motility disorders. The present review extends beyond a simple overview of EndoFLIP applications by providing a comprehensive evaluation of its performance in comparison with other diagnostic modalities, as well as the current knowledge gaps regarding its use. Study limitations and procedure-related aspects requiring further investigation are critically discussed, with the aim of supporting and guiding future research in this field.