The algorithm for pathologic GERD. The Milan score is a validated high resolution manometry screening tool that helps physicians to determine the risk of pathologic GERD. It includes four variables: EGJ type, Ineffective esophageal motility (IEM), EGJ contractile integral (EGJ-CI) and the response to the straight leg raise maneuver (SLR). The sum of each parameter generates the Milan Score and a risk rate for an acid exposure time (AET) >6% at the pH-study.