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What Is Esophageal Dysmotility?

The esophagus transports food from the mouth to the stomach.
Botulinum toxin is a treatment option for esophageal dysmotility.
Esophageal dysmotility causes pain when swallowing.
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  • Written By: Emma Lloyd
  • Edited By: A. Joseph
  • Last Modified Date: 13 October 2014
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The function of the esophagus is to transport food from the mouth to the stomach. For food to be transported efficiently and correctly, the muscles of the esophagus must coordinate in a very structured fashion to transport food to the stomach while ensuring that the stomach contents do not escape. An esophageal dysmotility disorder is one in which this process has been disrupted. These types of disorders can prevent food from being delivered to the stomach or cause stomach contents to be regurgitated. These problems can lead to esophageal dysmotility symptoms such as chest pain, pain when swallowing or the feeling of a permanent lump in the throat.

Esophageal dysmotility disorders have a wide range of causes and effects. One disorder, called spastic esophageal motility disorder, is caused by an imbalance between nerve pathways that cause esophageal muscles to relax and contract. This imbalance leads to muscle spasms that cause difficulty and pain when swallowing, chest pain and acid reflux.

In the case of esophageal achalasia, the disorder is caused by the inability of the esophageal sphincter muscle to relax. This muscle normally relaxes and tightens in response to certain cues, so that food can pass into the stomach while preventing regurgitation of the contents of the stomach. In achalasia, the constant rigidity of the muscle causes difficulty swallowing food and drink, heartburn, coughing, chest pain and regurgitation of stomach contents, including stomach acid.

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Another esophageal dysmotility disorder, called scleroderma, develops as the result of the build-up of scar tissue in the esophagus. Scleroderma is the result of an autoimmune disease in which cells of the immune system attack different cell types in the body, including esophageal cells. Over time, chronic inflammation and irritation lead to the formation of scar tissue. This scar tissue weakens the muscles of the esophagus, causing difficulty and pain when swallowing. As the disease progresses, it can cause chronic acid reflux and increase the risk of esophageal cancer.

Dysmotility disorders of the esophagus are generally incurable. The main objective of treatment is therefore symptom management and relief. Several types of medication can be used for dysmotility treatment, including calcium channel blockers and botulinum toxin. Dietary modifications can help relieve symptoms, and some disorders can be improved with surgery.

The primary medications used to treat esophageal dysmotility disorders such as achalasia are calcium channel blockers. These medications are useful because they make swallowing easier by reducing the strength of muscular contractions, including the sphincter muscle of the esophagus. Another medication option is botulinum toxin, also known as Botox®. This medication prevents strong muscle contractions because it causes partial muscle paralysis. Finally, some antidepressant medications help reduce chronic pain and might be prescribed for people who experience chronic chest pain because of dysmotility disorders of the esophagus.

Some dysmotility disorders can be treated with surgery. In the case of achalasia, the most common procedure is a Heller’s myotomy, in which the sphincter muscle is cut so that it is no longer permanently contracted. This procedure also is performed to treat other types of esophagus dysmotility, including spastic esophageal motility disorder.

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anon951009
Post 13

I have just been diagnosed with esophageal dysmotility. I am 72 years old and when I was about 12 years old I had radium treatments for sinus problems. A long rod was inserted in each nostril with the treatment of radium on the end of each rod. This was done at three different times. I believe this has always caused my problem of swallowing, especially large pills. I did not know that chest pain and coughing went along with this problem.

I also have these. Could the stupidity of a doctor years ago have caused my problems now? -- Eva

anon347280
Post 12

I have just been diagnosed with esophageal dysmotility. It was diagnosed following testing for my hiatal hernia. Half of my stomach is under my diaphragm. I will be seeing a surgeon tomorrow for the hernia, but have been told that prior to surgery, I will need to do more testing for the esophagus, called an esophagus manometry. I guess what I don't understand is why I would need to have more tests when I already have this diagnosis.

anon342768
Post 11

I just found out that this is what I have. It's been five years. My symptoms are feeling like I need to burp/vomit/regurgitate all the time. If my stomach is empty, I will vomit air. If full, the air will push food back up with it, unless I'm careful.

I kind of have to come up with a new career idea because they wont let me in the army. That was my only dream. There is nothing else I want.

anon340839
Post 10

I have just been diagnosed with dysmotility and nutrient malabsorption, a terrible unknown bowel issue and had my gallbladder removed. I was told it was because I used to be a smoker.

anon327662
Post 9

I had d-bypass in 06 and have had problems with esophageal dysmotility since. I am in e.r. room once every two months with severe chest pain. I've had every test done under the sun and still no relief. I feel like it controls my life. Is there some sort of diet and natural pills to help? I hate these anti-depressants!

anon270649
Post 8

I have had this condition for nearly five years now, my symptoms are severe chest pain, and constant coughing. I am on 15 tablets a day now, which does ease the coughing but not the pain. I sleep slightly elevated of a night which does help, but when I wake in the morning, I have to clear my chest of any saliva that has laid on it overnight. This is a lifelong condition that often flares up, but hey ho, what can I do but live with it?

anon259644
Post 7

I have just been diagnosed with esophageal dysmotility, and have been suffering for a long time; my bowels even quit moving. My doctor has put me on Reglan, taken a half hour before each meal, Gas X, and eating six or more times a day, very light, soft food and small meals. Anything that causes a flare, don't eat it.

More tests are to be done on me to check for autoimmune diseases. I hope this helps!

anon253066
Post 6

I have been having problems for years. Food gets stuck going down and I have a really bad ache in my chest.

anon174831
Post 5

how do they test for it?

anon162752
Post 4

I have suffered with esophageal dysmotility for almost two years. This condition causes constant misery, and has totally ruined my life. Has any other sufferer found a drug that helps relieve symptoms? The doctors don't seem to know much.

anon136694
Post 3

I have had Barrett's Esophagus with increasing complications for over 10 years. Has any medical connection been made to ionizing radiation and these conditions?

I served in the USAF and was exposed to nuclear fallout during spring/summer of 1958 at Eniwetok. i have a claim in with the VA but they state it is not a proven connection until it becomes cancerous.

anon124161
Post 2

I know how you feel. sometimes it helps to watch what you eat: no acid, no coffee, no sodas and no fat. i just found that i have that problem. i know how much pain you have because i have it.

anon122719
Post 1

I have been diagnosed with esophageal dysmotility. I cannot vomit and I am in excruciating pain. What shall i do? I cannot make myself sick no matter how sick I feel or how hard I try. thanks. --lenka

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