Motility Disorders: Gastrointestinal | MedStar Health

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What are gastrointestinal motility disorders?

"Gastrointestinal motility disorders” is an umbrella term describing various conditions that affect the movement of food, liquid, and waste throughout the gastrointestinal (GI) tract. Motility disorders occur when intestinal muscles or nerves don’t contract or relax properly. They are often grouped by the affected organ, with the most common types including:

What is a gastrointestinal motility specialist?

If you have symptoms of a GI motility disorder, your primary care provider may refer you to an expert in these conditions, called a gastrointestinal motility specialist (GI motility specialist).

At MedStar Health, we provide multidisciplinary care from various specialists who work together to evaluate your condition and tailor treatment based on your unique needs and preferences. Your care team may include a gastrointestinal motility specialist, as well as experts in surgery, primary care, radiology, and other specialties. Our goal is to help you feel confident making decisions about your treatment, so you can experience relief and an improved quality of life.

What GI motility disorders do you treat?

Examples of GI motility disorders and symptoms we treat include:

What are the signs and symptoms of gastrointestinal motility disorders?

Motility disorder symptoms will vary based on which organ is affected. In general, potential signs of a motility disorder may include:

  • Difficulty or pain swallowing

  • Heartburn and acid reflux

  • Diarrhea

  • Nausea

  • Constipation

  • Stool incontinence

  • Bloating and gas

  • Vomiting

What causes motility disorders?

Motility disorders are often caused by several factors, including:

  • Genetics

  • Certain medications, such as opioids

  • Environmental exposures

  • Certain conditions that can predispose you, including:

    • Diabetes

    • Thyroid disease

    • Neurological conditions, such as Parkinson’s disease

    • Autoimmune disorders

How are motility disorders diagnosed and treated?

To diagnose motility disorders, we conduct a physical exam, discuss your medical history, review your medications, and ask questions about your symptoms. In addition, we use the latest in advanced diagnostic technology to understand your condition and pinpoint the root cause of your symptoms. Often, we’ll begin with a colonoscopy or endoscopy exam to visualize the GI tract and rule out any structural issues. Then, we’ll use additional specialized tests to further evaluate a particular organ, based on your symptoms.

Diagnostic tests and treatment for motility disorders of the GI tract vary depending on the affected organ. Our comprehensive treatment approach ensures you have access to a variety of options, from simple lifestyle changes and medications to endoscopic therapies and minimally invasive surgeries that offer hope for relief.

Learn more below.

  • Esophageal motility disorders 

    Diagnosis

    Once we’ve ruled out any structural abnormalities in the esophagus, we may use one or more of the following motility tests to further understand your condition:

    • High-resolution esophageal manometry: During this test, we place a very thin catheter through the nose down into the esophagus while you’re awake. Then, we have you drink water. As the water moves down the esophagus, sensors pick up on how the esophageal muscles are contracting and the sphincter is opening appropriately.

    • EndoFlip: This is a newer tool that measures motility through the esophagus using a similar catheter attached to a balloon. This test is placed in your mouth while you’re asleep. Then we inflate the balloon slowly, which helps to stimulate contractions so we observe how the muscles and sphincter are working.

    • pH monitoring: If you have heartburn or acid reflux, we can use pH tests to measure the amount of acid in your esophagus.

    Treatment

    Treatment depends on the cause of your symptoms. For example:

    Achalasia is a rare swallowing disorder that can cause chest pain or difficulty swallowing because the esophageal sphincter isn’t relaxing properly. Treatments may include:

    • Endoscopic therapies, including a dilation procedure to stretch the sphincter
    • Botox injections
    • Surgery

    Learn more about achalasia

    Gastroesophageal Reflux Disease (GERD) symptoms, such as heartburn or acid reflux, are very common. If you have GERD, your healthcare provider will recommend lifestyle changes along with other potential treatment options, such as medication or surgery.

    Learn more about GERD

  • Gastric motility disorders

    Diagnosis

    Gastroparesis is a motility disorder causing the stomach to digest and empty more slowly than normal, which leads to symptoms such as nausea, vomiting, bloating, and discomfort. In the majority of cases, the exact cause of gastroparesis is unknown (idiopathic). Known causes include diabetes, viral illness, and vagal nerve injury due to surgery.

    To further assess symptoms and conditions affecting the stomach, a gastric emptying scan may be used to assess how long it takes for your stomach to empty into the small intestine.

    Treatment

    Diet modification and medications are common ways to treat gastroparesis. However, sometimes the symptoms persist despite these treatments. For these persistent symptoms, Medstar Georgetown University Hospital is one of a few centers to offer Gastric Electrical Stimulation, a novel, minimally invasive, surgically implanted device that gently stimulates the nerves in your stomach to reduce the chronic nausea and vomiting symptoms of gastroparesis.

    Unlike other surgical treatment options, the Gastric Stimulator can be customized to address your individual needs. It may later be removed, if desired.

  • Intestinal motility disorders

    Diagnosis

    If your doctor recommends additional testing, you may undergo blood tests which can evaluate for other gastrointestinal conditions. Other diagnostic tools may include breath tests or additional imaging tests.

    Treatment

    IBS is one of the most common motility disorders affecting the colon. Treatment often includes dietary and lifestyle modifications, along with emotional well-being support, and sometimes medication.

    Learn more about IBS treatment

  • Pelvic floor motility disorders

    Diagnosis

    Weakness or injury can lead to a range of symptoms affecting your ability to go to the bathroom. Anal rectal manometry measures the pressure and coordination of the muscles in your rectum, anus, and pelvic floor.

    Treatment

    Pelvic floor therapy can help to strengthen pelvic muscles and improve your quality of life.

    Learn more about pelvic floor therapy

Our providers

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Research and clinical trials

We continue exploring new ways to diagnose and treat patients with motility disorders of the GI tract. A current area of study is the use of a gastric stimulator to help patients with severe gastroparesis.

Patient resources

  • Ask a Gastrointestinal Motility Specialist: Dr. Angelic Nocerino

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Related services

Achalasia


Chronic Constipation


Diarrhea


Emergency Medicine


Fecal Incontinence


Gastroenterology


GERD (Acid Reflux)


Irritable Bowel Syndrome (IBS)


Pelvic Floor Therapy


Pharmacy


Primary Care