Background <p>With the introduction of high-resolution manometry (HRM), esophageal motility disorders (EMDs) are now better understood, allowing for a more effective treatment. Carbonated water use was suggested to change esophageal motility. Hence, this study sought to determine the effect of carbonated water on esophagus HRM. In this retrospective study, we used manometry to evaluate the effects of carbonated water on esophageal movement and to investigate the potential impact on the diagnosis and interpretation of motility disorders.</p> Methods <p>We enrolled 110 patients who underwent HRM examination with still water or carbonated water use. We compared the manometry metrics and the final diagnosis of EMDs between patients taking still water or carbonated water.</p> Results <p>Carbonated water consumption could increase the distal contractile integral (DCI) in the upright position (<i>p</i> &lt; 0.001) and reduce the integrated relaxation pressure (IRP) in the supine position (<i>p</i> &lt; 0.001). Therefore, in the supine position, 9.1% (10/110) of patients had their manometry diagnosis change from EMDs to a normal result after using carbonated water. Moreover, 14.5% (16/110) changed to normal results from EMDs in upright position.</p> Conclusions <p>The present study found carbonated water could increase the DCI in the upright position and reduce the IRP in the supine position. These findings suggest that carbonated water may influence HRM parameters in a way that helps clarify borderline motility patterns, although their diagnostic value remains to be confirmed.</p> Graphical abstract <p></p>