The specialists at The Ohio State University Wexner Medical Center who deal with digestive issues understand that the pain and discomfort of motility disorders can impact your daily life in significant ways. Our goal is to help pinpoint a diagnosis and design a treatment program that delivers relief and real improvement in your quality of life.
What is a Gastrointestinal Motility Disorder?
Gastrointestinal (GI) motility disorders occur when the nerves and muscles in the gastrointestinal tract are not working correctly, causing abnormal contractions or increased sensitivity. A person can be born with a motility disorder or it can develop later in life, often after chronic inflammation or an infection happens in the GI tract.
A motility disorder can occur anywhere within the digestive tract, from the esophagus to the rectum, so issues are categorized into two groups. Upper gastrointestinal motility disorders involve the esophagus, stomach or upper part of the small intestine. Lower gastrointestinal motility disorders involve the small intestine, colon (or large intestine) and rectum.
- Difficulty or pain with swallowing
- Heartburn, acid reflux or unexplained chest pain
- Abdominal fullness or swollen stomach
- Gas, bloating and burping
- Pain or discomfort in the abdomen or anus
- Constipation—two or fewer bowel movements each week, hard stools that are difficult to pass, excessive straining when trying to have a bowel movement, feeling that you have not completely emptied after a bowel movement
- Unexplained nausea or vomiting
- Chronic diarrhea
- Involuntary leakage of stool
- Mucus discharge from the anus
- Pain or bleeding when passing stools
Should you experience any of the above symptoms, as well as other unexplained digestive problems, or have not been given a definitive diagnosis, the experts at Ohio State will work with you to help pinpoint your issue.
Although motility disorders are often difficult to diagnose and manage, close partnership between the patient and Ohio State specialists can lead to significant improvement.
Your Ohio State gastroenterologist will collect your complete medical history, discuss your symptoms, evaluate your digestive functions and schedule any required testing.
- Basic imaging studies, such as X-ray, magnetic resonance imaging (MRI) or CAT-scan, can be used to see if there is any narrowing, inflammation or growth that explains your symptoms. You may also need a colonoscopy or endoscopy, which involves placing a small camera attached to the end of flexible tube into your digestive tract while you are under sedation to provide a clear view of any issues within your bowels.
- If the above tests do not reveal a clear cause of symptoms, manometry or transit testing may be required depending on your symptoms.
- Esophageal manometry testing is used when patients suffer esophageal symptoms like heartburn, difficulty swallowing or chest pain. The test uses a thin, pressure-sensitive tube to measure muscle contractions and identify spasms. You may also have a test to check the pH level in your esophagus to see if you have significant acid reflux.
- Anorectal manometry testing is often used for patients with constipation, bloating or pain to measure the strength of anal muscles, sensations in the rectum and the reflexes needed for normal bowel movements.
- In transit studies, the patient swallows food or a small capsule to see how it moves through the digestive tract and how completely the bowels are emptied.
- For functional imaging studies a patient may swallow barium, a chalky white substance that coats the inside of your GI tract, to make it easier to see details of an X-ray or MRI.
Whatever testing is necessary, your Ohio State physician will explain each option and why it can prove helpful. Ultimately, the goal is to understand your specific condition and what treatment may be most effective in the long run.
Although not a comprehensive list of all motility disorders, the most common diagnoses include:
- Gastroesophageal reflux disease (GERD) – stomach acid backs up into the esophagus, causing a burning sensation
- Hiatal hernia – the upper part of your stomach bulges through a small tear in the diaphragm, which can allow acid into your esophagus
- Achalasia – the muscle between your esophagus and stomach does not open correctly when swallowing, which leads to a backup of food
- Chronic intractable constipation – infrequent bowel movements and hard stools that do not respond to standard laxative therapy or changes in diet and lifestyle
- Spastic esophageal disorder – uncoordinated muscle contractions in the esophagus that can cause pain, difficulty swallowing or throwing up
- Aerophagia – excessive swallowing of air when talking, eating or laughing that leads to abdominal discomfort
- Chronic pseudo-obstruction – problems with the nerves or muscles prevent food, liquid or air from moving easily through the digestive tract
- Gastroparesis – the stomach does not completely empty, which can cause nausea, vomiting and problems with blood sugar levels and nutrition
- Hirshsprung’s disease – present at birth, the large intestine is missing muscle nerves needed for passing stool
Following diagnosis of any gastrointestinal motility disorder, you will partner with a team of Ohio State experts that may include physicians, surgeons, nurses, psychologists, dietitians, physical therapists and others to create a treatment plan tailored to your individual situation and lifestyle goals.
For many patients, medication, simple diet or lifestyle changes or various therapies can lead to dramatic improvement. If these options are not appropriate or fail to produce desired results, surgery can then be considered for a more permanent solution.
Just a few examples of treatment supported at Ohio State:
- Lifestyle measures to reduce reflux, including stopping use of alcohol or tobacco, eliminating spicy or acidic foods or wearing more loose-fitting clothes
- Diet modifications, such as increasing fiber intake
- Low FODMAP diet, which eliminates carbohydrates that cause discomfort
- Diaphragmatic breathing to help you change your actual process of breathing and improve breathing efficiency
- Psychological counseling to change harmful patterns of behavior or introduce helpful habits
- Physical therapy to strengthen muscles or change the process of eating and drinking
- Medication or nutritional supplements
Whether one or multiple treatment approaches are required, your Ohio State team will work together to coordinate each aspect of your care. We strive to make it as easy as possible for you to manage appointments and follow all recommended parts of your treatment plan.
Why Choose Ohio State?
As an academic health center, The Ohio State Wexner Medical Center offers the latest treatment options delivered by experts who understand the complexity of the digestive system. Because the digestive tract can be impacted by so many different factors, having people from a range of specialties working on your individual case can change everything. Ongoing research related to digestive motility disorders also ensures access to new therapies that may not be available elsewhere.