Multichannel intraluminal impedance (MII) is a new technology that allows detection of bolus movement without the use of external radiation or radiolabeled substances. The principles of MII are based on changes in resistance to alternating electrical current (impedance) induced by the presence of various boluses within the esophagus. The timing of changes in multiple impedance-measuring segments in the esophagus allows determination of the direction of bolus movement. Combined MII and manometry (MII-EM) provides simultaneous information on intraesophageal pressures and bolus transit, offers the ability to monitor all types of reflux, and allows the detection of the physical (liquid, gas, or mixed) and chemical (acid, nonacid) characteristics of the gastroesophageal refluxate.