Gastrointestinal Motility Program
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Gastroenterology Referrals
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Gastrointestinal motility (also often referred to as “bowel motility”) is the movement and contraction of the muscles in the gastrointestinal tract needed to mix and move food and liquids through the digestive process. One in every 10 children in the United States will experience some form of motility gastrointestinal disorder. Many of these disorders can be challenging to diagnose, and therefore, challenging to treat.
The specialists at the CHOC Gastrointestinal Motility Program work to help families who have seen many doctors and tried many treatments yet still do not have a satisfactory explanation for their child’s suffering. Our comprehensive approach to diagnosing and treating motility and functional gastrointestinal disorders gives patients and their families the answers and relief that they are seeking.
What We Treat
Our gastrointestinal motility specialists diagnose and treat all forms of motility disorders, including the following conditions:
- Esophageal achalasia
- Gastroesophageal reflux disease
- Swallowing problems
- Pseudo obstruction
- Hirschsprung’s disease
- Anal Achalasia
- Irritable bowel syndrome.
We also work with families to diagnose and treat chronic conditions that have not previously responded to treatment, including:
- Constipation
- Fecal incontinence
- Vomiting
- Abdominal pain.
A Team Approach to Care
Our gastrointestinal motility specialists work to quickly see each patient for an initial evaluation soon after referral. They listen to all patient and family concerns related to the child’s condition and address each and every one. Teaming with the patient and his or her family, as well as referring physicians, nurses and nurse practitioners, rehabilitation therapists, dietitians, psychologists, pharmacists, surgeons and other medical specialists as needed, our motility specialists develop a unique treatment plan that is mindful of each child’s medical, emotional and social needs both now and in the future. They are dedicated to standing by our patients’ sides every step of the way.
Children with bowel motility problems can experience a variety of symptoms including abdominal pain, vomiting, diarrhea, poor growth or weight gain and much more. Because of these painful, and often life-altering symptoms, we understand how important it is to find effective treatments for motility problems as quickly as possible. Figuring out a child’s exact diagnoses often requires sophisticated tests that go inside the body. Tests that go inside the body allow the child’s health care team to get a better understanding of what may not be working right when the child is digesting foods and liquids. Our experts use a variety of tests to diagnose motility problems, including:
Anorectal Manometry
A non-invasive test that measures rectal nerve reflexes, pressure of the anal sphincter, coordination between the muscles involved in defecation, and the ability to squeeze and sense. It provides insight into the underlying problems in the mechanics of defecation.
Colonic Manometry
This test measures contractions in the colon. It provides an understanding of the underlying movement in the colon.
Esophageal Manometry
This test is used to figure out how well the esophagus is working by measuring the pressure and coordination of the esophageal muscles.
Antroduodenal Manometry
This test measures how your child’s stomach and intestines move.
Bravo pH Capsule Study
The BRAVO® capsule is a wireless method to measure the amount of acid from the stomach that goes into the esophagus (acid reflux).
pH-Impedance Study
An impedance study with pH monitoring determines if contents from the stomach are coming up into the esophagus (food tube), by evaluating acid and non-acid gastroesophageal reflux. This is one of the best possible tests for diagnosing gastroesophageal reflux disease.
Gastric Emptying Studies
Gastric emptying is a test that measures the time it takes for food to empty from the stomach and enter the small intestine.
Colorectal Transit Study
This study measures the time needed for stool to pass through the gastrointestinal tract, and utilizes X rays and radio-opaque markers.
Defecography
Defecography uses an X-ray to look at the shape and position of the rectum as it empties.
Once a child’s condition has been diagnosed, our experts team up with the child, his or her family and other medical specialists as needed to create a treatment plan. Although surgery may be a necessary treatment for some patients, others may benefit from the many nonsurgical treatments available at CHOC including:
Botox Injections
Botulinum toxin injections are used to relieve increased pressures in the anus in conditions such as anal achalasia or post-surgical Hirschsprung’s disease patients.
Cecostomies for Antegrade Colonic Enemas
A procedure that is done to relieve severe constipation that does not respond to medications.
Biofeedback Therapy
Scheduled sessions involve patients utilizing their abdominal and rectal muscles to control computer programs much like a video game. The goal of this type of treatment is to “retrain” the coordination between the muscles and nerves that are used for bowel movements. Learn more about biofeedback therapy.