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Home > Archive > Heartburn Support > June 2006 > How do you treat a Motility Disorder?
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How do you treat a Motility Disorder?
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| MrUsaMike 2006-06-26, 9:23 pm |
| Hello Fellow Members:
I have a possible motility disorder. Which might explain the weakness
and nausea. I get the final diagnosis sometime this weak. Does this
mean that my food is going too fast through my digestive system? What
type of treatment am I looking at?
Mike
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| Howard McCollister 2006-06-27, 2:26 am |
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"MrUsaMike" <mrusamike@hotmail.com> wrote in message
news:1151372649.285610.175380@b68g2000cwa.googlegroups.com...
> Hello Fellow Members:
>
> I have a possible motility disorder. Which might explain the weakness
> and nausea. I get the final diagnosis sometime this weak. Does this
> mean that my food is going too fast through my digestive system? What
> type of treatment am I looking at?
>
> Mike
>
Do you mean an esophageal motility disorder? That should have been picked up
on the pre-op esophageal manometry testing.
What are your symptoms, exactly? Do you have diarrhea as part of the symptom
set?
HMc
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| MrUsaMike 2006-06-27, 2:26 am |
| Hello Howard:
Well its not confirmed yet. I do have loose stool and green stool.
(sounds like cat in the hat) The GP guessed it might be Bile. I know
its late in the game, but what type of test do they do to determine
esophageal motility problems? They ruled out the thyroid today. They
are still trying to determine if my weakness/ featgue is slow recovery
or other GI issues. However all blood tests, and they have been
extensive, are normal....
Mike
Howard McCollister wrote:
> "MrUsaMike" <mrusamike@hotmail.com> wrote in message
> news:1151372649.285610.175380@b68g2000cwa.googlegroups.com...
>
> Do you mean an esophageal motility disorder? That should have been picked up
> on the pre-op esophageal manometry testing.
>
> What are your symptoms, exactly? Do you have diarrhea as part of the symptom
> set?
>
> HMc
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| Howard McCollister 2006-06-27, 8:24 am |
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"MrUsaMike" <mrusamike@hotmail.com> wrote in message
news:1151378992.517490.150730@m73g2000cwd.googlegroups.com...
> Hello Howard:
>
> Well its not confirmed yet. I do have loose stool and green stool.
> (sounds like cat in the hat) The GP guessed it might be Bile. I know
> its late in the game, but what type of test do they do to determine
> esophageal motility problems? They ruled out the thyroid today. They
> are still trying to determine if my weakness/ featgue is slow recovery
> or other GI issues. However all blood tests, and they have been
> extensive, are normal....
>
> Mike
>
Before doing any anti-reflux surgery, it's pretty standard to assess the
strength of the esophagus, the strength of the LES, and the coordination of
the esophagus in its ability to move food along. This would have been a test
where a tech puts a small catheter down your nose into the stomach, then
pulls it back a centimeter at a time and asking you to swallow little
boluses of water or other more viscous liquid. This is done in an attempt to
make sure that the esophagus is working properly and that an anti-reflux
operation won't excessively impede swallowing.
A set of symptoms such as you describe after a Nissen fundoplication would
make me wonder about the possibility of an injury to the posterior vagus
nerve. That nerve is potentially in jeopardy during that operation, and
injuring it would affect the motility of the entire GI tract. This would
especially affect gastric emptying, but post-vagotomy diarrhea and/or
dumping syndrome are well-recognized complications.
My approach would be to try to assess gastric emptying and small bowel
transit with an upper GI contrast swallow. The barium can be tracked through
your upper GI tract, observing slow gastric emptying and/or rapid transit
through your small intestine.
HMc
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| Richard Kaszeta 2006-06-27, 8:24 am |
| "Howard McCollister" <nospam@nospam.net> writes:
> Before doing any anti-reflux surgery, it's pretty standard to assess the
> strength of the esophagus, the strength of the LES, and the coordination of
> the esophagus in its ability to move food along.
Indeed, when I had my Nissen, the surgery team insisted on several tests:
- Manometry (which had already been done diagnosing the GERD along
with the pH monitoring test , so I didn't have to redo this one)
- A barium swallow test (as Howard describes below)
- A gastric emptying test (radioactive oatmeal, and they watch you
until the oatmeal has passed from your stomach)
The pH monitoring test (with a transmitter pill the second time) and
barium swallow were repeated after surgery when I had a return of
symptoms. And after 6 months my new clinic (I moved cross country)
had another endoscopy to make sure everything looked fine.
> My approach would be to try to assess gastric emptying and small bowel
> transit with an upper GI contrast swallow. The barium can be tracked through
> your upper GI tract, observing slow gastric emptying and/or rapid transit
> through your small intestine.
This is basically what my surgery team did with me.
--
Richard W Kaszeta
rich@kaszeta.org
http://www.kaszeta.org/rich
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