GASTROINTESTINAL MOTILITY DISORDERS

A careful history can localize gastrointestinal motility disorders and suggest appropriate diagnostic tests. Dysphagia, odynophagia, heartbu rn and reflux have esophageal origins. The same symptoms occur in acha lasia, a classic motor disorder of the lower esophageal sphincter, whi ch can be diagnosed by barium swallow, endoscopy and esophageal motili ty studies. Nausea, vomiting, anorexia, bloating and abdominal pain ar e symptoms of motor disorders of the stomach and small intestine. When these symptoms are accompanied by unexplained right upper quadrant pa in, elevated liver enzyme levels and unexplained recurrent pancreatiti s, the diagnosis of impaired biliary motility is suggested. Colorectal motility disorders may present as abdominal pain, diarrhea, constipat ion and/or fecal incontinence. If symptoms do not resolve with dietary changes and appropriate medications and the anatomy is normal on lowe r gastrointestinal studies, colorectal motility studies may be indicat ed.