Esophageal Testing For Motility Disorders Specialist

What is esophageal motility disorder?

The purpose of the esophagus is to move chewed food and drink from the mouth to the stomach for the start of digestion. The esophagus consists of a series of muscles and sphincters that must operate in a specific order to move the contents of the mouth efficiently to the stomach. A motility issue means that somewhere in that series of motions, something is not operating correctly. These disorders are common and occur on a spectrum related to systemic diseases known as secondary motility disorders. The condition typically presents symptoms like chest pain and dysphagia, which means difficulty or discomfort in swallowing.  

What is esophageal testing for motility?

There are a variety of tests which can measure the effectiveness of the esophagus.

• Esophagram: This test involves the patient swallowing barium, a contrast agent while a radiologist uses fluoroscopy to monitor its movement through the esophagus. This can detect a hiatal hernia or stricture in the esophagus.
• Upper Endoscopy: During this test a small camera on a thin flexible tube is fed through the upper gastrointestinal system allowing the doctor to see any damage like ulcers or esophagitis.
• Esophageal manometry: The patient has a small tube passed through the throat and is then asked to swallow. The tube takes measurements of the pressure from the esophageal contractions.

Why would motility testing be ordered?

Motility testing can show the doctor more information about the condition causing a patient’s symptoms and ensure that the correct diagnosis is made and a treatment plan formulated. Motility testing is often one of the first rounds of tests ordered when patients have gastrointestinal symptoms, as the screenings allow doctors to rule out functionality issues before ordering further testing for other conditions.  Some of the motility disorders that the testing can diagnose include:

• Diffuse esophageal spasm is a rare swallowing disorder characterized by forceful but poorly coordinated muscle contractions.
• Achalasia occurs when the lower sphincter in the esophagus does not relax sufficiently to allow food to enter the stomach.
• Scleroderma is a rare and progressive disease where the muscles in the lower esophagus stop moving, resulting in severe reflux.

How can a patient prepare? What should a patient expect?

The night prior to the procedure, the patient shouldn't eat or drink after midnight. A small probe is inserted into the right or left nare that has pressure sensors. The contractions of the esophagus are measured and graphed.