Esophageal Motility Disorders Specialist

What are esophageal motility disorders?

Esophageal motility disorders are a group of conditions that affect the passage of food from your mouth to your stomach.

When you eat, you don't think much about the process of swallowing, but it actually requires your body to perform a carefully coordinated series of actions. First, the upper esophageal sphincter (UES), a band of muscle at the top of your esophagus, needs to open.

As you swallow, peristalsis — rhythmic muscular contractions — propels the chewed food down your esophagus. At the right time, the lower esophageal sphincter (LES), a band of muscle that stops stomach acid refluxing up your esophagus, needs to open to let the food into your stomach.

Any problem with these actions results in an esophageal motility disorder.

What kinds of esophageal motility disorders are there?

The most common esophageal motility disorders are:

Achalasia

Achalasia is a condition where the LES can't open properly due to nerve dysfunction. Food then can't get into your stomach.

Eosinophilic esophagitis

Eosinophilic esophagitis is an inflammatory disease where the wall of your esophagus fills with white blood cells called eosinophils. It might be due to a food allergy.

Esophageal spasm

Esophageal spasm is a condition that interferes with peristalsis in your esophagus, so you can't propel swallowed food down to your stomach properly.

You could also develop an esophageal motility disorder as a symptom of a whole-body disease like systemic sclerosis or Chagas disease.

What symptoms do esophageal motility disorders cause?

Esophageal motility disorders can cause symptoms such as:

• Difficulty swallowing (dysphagia)
• Heartburn
• Chest pain
• Regurgitation of food
• Vomiting
• Aspiration of food

Aspirating food means that food particles go into your airways instead of your stomach. This can lead to choking and, subsequently, infections such as pneumonia.

How are esophageal motility disorders treated?

Treatment for your esophageal motility disorder depends on which condition you have and how severe it is.

Eosinophilic esophagitis is treatable using medications such as calcium channel blockers or injections of medical Botox®.

A coating of corticosteroid medication on your esophagus can help to reduce inflammation. You can use a fluticasone inhaler to puff the steroid into your mouth or swallow liquid budesonide mixed with a sugar substitute or a thickening agent.

Would I need surgery for an esophageal motility disorder?

If noninvasive therapies aren't working, you might require a more invasive procedure.

For instance, if your esophagus is narrowing, your provider at the Center for Advanced Surgery might use an endoscope (long, flexible tube) to insert a medical balloon into your esophagus. Inflating the balloon when it's in position helps widen your esophagus.

Surgical procedures for esophageal motility disorders include esophagomyotomy (Heller myotomy) to release the LES. Alternatively, per oral endoscopic myotomy (POEM) can achieve the same outcome using endoscopic techniques.

To find out more or discuss any current symptoms you have, call the Center for Advanced Surgery today or book an appointment online.

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