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Esophageal Dysmotility

WHAT IS ESOPHAGEAL DYSMOTILITY?

Normally, the tongue pushes foods and liquids from the mouth to the throat. The foods and liquids then pass from the throat into the esophagus, which is the tube they travel through to the stomach. To keep foods or liquids moving to the stomach, the esophagus muscles tighten and relax in a wave-like motion.

With esophageal dysmotility, foods and liquids do not easily pass down the esophagus. This causes problems swallowing.

The board-certified gastrointestinal specialists at Loma Linda University Health provide advanced care for the most complex conditions, including esophageal dysmotility. We treat more people with esophageal conditions than any center in the region.

WHAT ARE THE SYMPTOMS OF ESOPHAGEAL DYSMOTILITY?

The symptoms of esophageal dysmotility may include:

  • Heartburn
  • Regurgitation
  • Chest pain
  • Difficulty swallowing
  • The feeling that food is stuck in the throat or chest
  • Weight loss and malnutrition
  • Recurrent bouts of pneumonia

WHAT CAUSES ESOPHAGEAL DYSMOTILITY?

Esophageal dysmotility may be caused by:

  • An ulcer, stricture, irritation, infection, inflammation, or cancer in the esophagus
  • Uncoordinated or abnormal muscles in the mouth, throat or esophagus
  • A nerve or brain problem (such as a stroke) that leaves the mouth, tongue or throat muscles weak (or changes how they coordinate)

HOW IS ESOPHAGEAL DYSMOTILITY DIAGNOSED?

If a doctor suspects esophageal dysmotility, the diagnosis will begin with a physical examination and discussion of health history.

Tests and imaging techniques used to diagnose esophageal dysmotility might include:

  • Barium swallow study – These studies help to evaluate esophageal dysmotility
  • Endoscopy – This is used to look directly at the inner walls of the esophagus to evaluate the dysmotility. It is also used to exclude the presence of a tumor
  • Endoscopic ultrasound (EUS) – This is a procedure that combines endoscopy and ultrasound - this produces images and provides information about the digestive tract, surrounding tissue and organs
  • Esophageal manometry – This procedure is used to measure the function of the esophageal muscle
  • pH study – This study is done to assess for abnormal reflux

At Loma Linda University Health, the 14 specialists at our Digestive Disease Center are board-certified in gastroenterology. We offer the most advanced diagnostic technologies found only in major metropolitan academic medical centers.

HOW IS ESOPHAGEAL DYSMOTILITY TREATED?

Treatment for esophageal dysmotility will depend on the type of disorder and its underlying cause. Some common treatments include:

  • Medications to reduce the spasms
  • Botox (botulinum toxin) injections into the area of dysmotility
  • Balloon dilation of the lower esophagus to disrupt dysmotility
  • Heller myotomy, a minimally invasive, laparoscopic surgical procedure

WHO IS AT RISK FOR ESOPHAGEAL DYSMOTILITY?

People at risk for esophageal dysmotility include those who have:

  • Benign or malignant strictures
  • Esophageal motor disorders including:
    • Achalasia (in which the lower esophageal sphincter does not relax)
    • Esophageal spasm (in which esophageal contractions become uncoordinated)
  • Neurological or neuromuscular disorders such as:
    • Multiple sclerosis
    • Muscular dystrophy
    • Myasthenia gravis
    • Myopathy
    • Peripheral neuropathy
    • Spinal muscular atrophy
    • Myositis, including polymyositis and dermatomyositis
    • Charcot-Marie-Tooth disease
    • Amyotrophic lateral sclerosis (ALS)

NEXT STEPS

Be proactive. If you are experiencing the symptoms of esophageal dysmotility, seek medical attention. There are a variety of treatments that can address the condition; to learn which one may be right for you, request an evaluation at Loma Linda University Health. Contact your provider or schedule the appointment through MyChart.