Motility
Although we begin the act of swallowing
consciously, most of the complex maneuver that propels food from the mouth to
the stomach occurs independently of conscious thought and is controlled by the
esophagus. An esophageal motility study measures the muscular activity of the
esophagus during the act of swallowing.
The esophagus is the muscular tube connecting the mouth to the stomach. It runs
through the neck behind the windpipe to the chest, where it lies behind the
heart. The esophagus enters the stomach through an opening in the diaphragm, the
main muscle between the chest and abdomen.
An Esophageal Motility Study is performed in the hospital Gastroenterology Suite
after the patient fasts for 6 hours. A nurse passes a long tube a bit smaller
than a soda straw through the nose into the esophagus and stomach. The tube
contains sensors that measure the muscular activity of the esophagus in response
to small sips of water administered during the test. The entire test takes about
an hour to perform and the patient can resume usual daily activities afterward,
including eating. Interpretation of the test is performed later by the
gastroenterologist.
Motility studies are frequently used to diagnose swallowing problems in patients
who do not have any evidence of blockage of the esophagus during EGD. Achalasia,
a disease affecting the nervous supply to the esophagus and scleroderma, a
disease affecting many different parts of the body including the muscles of the
esophagus can be diagnosed by motility studies. Some patients who are scheduled
for surgery of the esophagus have motility studies to help the surgeon plan the
operation. Finally, patients who have chest pain that is not explained by
studies of the heart or lungs may have motility studies to help determine the
source of the pain.
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