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Normal contractions of the gut (called peristalsis) move
food down the intestinal tract from the oral cavity to the rectum and
facilitate absorption of nutrients. These peristaltic contractions occur when
the muscle layers of the gut and the nerves embedded in them work together in a
synchronized manner. Any abnormality in the gut muscle and/or nerves, whether
from birth or acquired, can disrupt the normal contractions and produce
symptoms. These could include difficulty swallowing, choking, gagging, aspirating,
vomiting, regurgitation, chest pain, abdominal pain or distension,
constipation, diarrhea, incontinence or soiling, and weight loss. Motility
disorders of the gut can occur in association with abnormalities in other organ
systems such as the central nervous system, mitochondrial disorders, muscular
dystrophies and others.
What are some
Tests are usually performed based on the symptom and the
segment of the gut affected. There are a host of tests that can be performed to
diagnose motility disorders. These include pH-impedance monitoring, manometry,
transit studies, gastric emptying scan, contrast radiologic studies etc.
One has to first diagnose a motility disorder and its type and then get an assessment of its severity. Depending on the type and severity, some of these disorders can be treated while others can be managed symptomatically. A minority of the more severe ones, however, can progress and worsen over time while others may need surgical intervention.
After we have reviewed all the past records and tests
results, we come up with a tentative plan for a thorough evaluation of your
child’s condition. This includes clinic visits, outpatient tests and often a
brief hospitalization for performing specialized testing. Once the diagnostic
evaluation is completed and all test results available, we typically
communicate with the referring doctor and the parent to give them our
impressions and recommendations.
Learn more about some of the tests that we perform, including esophageal manometry, antro-duodenal manometry and colonic manometry.
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