Gastrointestinal Motility Services
Gastrointestinal (GI) motility is a specialized subspecialty within gastroenterology that focuses on the functional movement and regulation of the muscles and nerves involved in the digestive process. This field is concerned with the normal and abnormal movements of the gastrointestinal tract, which are essential for proper digestion and absorption of nutrients. The motility of the GI tract encompasses processes such as esophageal peristalsis, gastric emptying, intestinal transit and coordinated contractions of the smooth muscle that facilitate digestion, nutrient absorption and elimination of waste.
GI motility disorders arise when these processes are disrupted, leading to symptoms such as chronic abdominal pain, bloating, acid reflux, nausea, vomiting, constipation, diarrhea and dysphagia (difficulty swallowing). Conditions like gastroparesis, achalasia, irritable bowel syndrome (IBS), chronic constipation, and small bowel dysmotility are all examples of GI motility disorders. These conditions can significantly impact a patient’s quality of life and are often complex to diagnose and treat due to the intricate nature of gastrointestinal function.
Our specialized GI motility services, led by the region’s only fellowship-trained gastrointestinal motility specialist, Sandeep Verma, MD, provide advanced diagnosis and treatment for complex conditions close to home. Patients benefit from access to testing and care that typically requires travel to out-of-state centers, integration with the full spectrum of gastroenterology services and opportunities to take advantage of the latest research and innovations in digestive health. Dr. Verma is a physician-scientist with a research background in human gut microbiome, and is working to further new treatments in the complex field of GI motility through evidence-based practice.
Conditions We Treat
Our GI motility program evaluates and treats a wide range of esophageal motility disorders, including:
- Achalasia: Failure of the lower esophageal sphincter (LES) to relax, preventing food from entering the stomach.
- Diffuse esophageal spasm: Uncoordinated contractions of the esophageal muscles that cause chest pain and difficulty swallowing.
- Hypercontractile esophagus: Excessive contractions of the esophageal muscles, leading to regurgitation and chest pain.
- Esophageal strictures: Narrowing of the esophagus due to inflammation, scarring, or a tumor.
- Eosinophilic esophagitis: Eosinophilic esophagitis is an inflammation of the esophagus caused by an overabundance of certain white blood cells. Food allergies are thought to be one cause of the condition.
- Scleroderma esophagus: A complication of scleroderma, an autoimmune disorder that affects the connective tissues. It occurs when the immune system attacks the muscles and lining of the esophagus, leading to inflammation and fibrosis (scarring).
- Gastroesophageal reflux disease (GERD): A condition where stomach acid flows back up into the esophagus, causing heartburn and other symptoms.
- Gastroparesis (slow gastric emptying) that can be associated with symptoms of gastroesophageal reflux, nausea, vomiting and anorexia.
- Gastric Stimulator (Enterra) Device management
- Cyclic vomiting syndrome: chronic disorder that causes sudden, severe, and recurrent episodes of nausea and vomiting. The episodes are separated by periods of completely normal health and often have a predictable pattern.
- Dumping syndrome: Dumping syndrome is a collection of symptoms that occur when the stomach empties its contents too rapidly into the small intestine.
- Functional or non-ulcer dyspepsia (NUD)
- Intractable or chronic constipation due to either slow transit or disorders of evacuation and fecal incontinence.
- Irritable bowel syndrome (IBS) with constipation or diarrhea
- Pseudo-obstruction (disorders of gastric and intestinal motility) that can be associated with all the above in addition to distension, bloating, abdominal pain, undernutrition, weight loss and constipation.
- Post-surgical motility problems
- Other functional gastrointestinal disorders
Advanced Diagnostic Testing
We use state-of-the-art testing to identify and measure motility problems, including:
- High-resolution esophageal manometry: a diagnostic test used to assess the function of the esophagus and provides detailed information about esophageal contractions, pressure and coordination.
- pH impedance testing: evaluates acid and non-acid reflux
- Wireless pH monitoring (BRAVO capsule study): a non-invasive procedure used to diagnose gastroesophageal reflux disease (GERD).
- SmartPill® motility testing: tracks movement throughout the digestive tract
- Gastric emptying studies: measures how quickly food leaves the stomach
- Whole gut transit (WGT) studies: by combining measures of gastric emptying, small bowel transit and colonic transit these studies identify dysmotility, which is an abnormal movement of the digestive system.
- Anorectal manometry: measures the pressure and function of the muscles in the anus and rectum
Personalized Care Plans
Our team works closely with each patient to create a personalized treatment plan, which may include dietary guidance, medication, minimally invasive procedures or referrals for advanced therapies. We coordinate with other specialists — such as dietitians, surgeons and pelvic floor therapists — to provide comprehensive, seamless care.
