Robert Burakoff, MD, MPH, Director of the Center for Digestive Health at Brigham and Women’s Hospital (BWH), discusses diagnosis and treatment of esophageal and motility disorders such as gastroesophageal reflux disease.
There are 30 to 40 million people in the United States that suffer from gastroesophageal reflux disease. Gastroesophageal reflux disease (GERD) is a condition in which the stomach contents leak backwards from the stomach into the esophagus. This can irritate the esophagus and cause heartburn and other symptoms. Other times the feeling of heartburn and indigestion can actually be due to an abnormality of how the esophagus contracts.
There are various factors that can lead to abnormality of how the esophagus contracts. It can be that the esophagus is very weak, and the contractions are very slow and poor, and that allows the liquids and solids to hold up in the esophagus. It can also be that the esophagus contracts too strongly. In some cases, patients can lose a nerve at the end of the esophagus and, as a result, the esophagus can't relax, and liquids and solids will sit in the esophagus, and the esophagus gets bigger and bigger.
At the BWH GI Endoscopy Center, as well as the GI Motility Center, clinicians evaluate patients to determine if they have a motility disorder, or if they have an increased acid reflux. A small tube is also used to pass through the patient’s nose into the stomach that allows the clinician to record how a patient swallows liquids and how well the esophagus contracts.
Learn more about esophageal and motility disorders:
Read the Esophageal and Motility Disorders - New Recommendations for Diagnosis and Treatment video transcript:
My reflux is due to a rare disease called LAMBERT EATON MYASTHENIC SYNDROME. If affects voluntary muscles and autonomic functions. My oesophagus is not working properly. The GERD and indigestion are causing me to have extra systole and this has gone into SVT. I take two 20mg tabs to control the reflux but I still seem to experience non acidic burping and indigestion - THIS is what seems to lead to the heart beats. I have had a gastroscopy which showed I have reflux but no damage. But oesophageal dysfunction. Is there any point putting myself through the manometry study if i already know the issue and it can't be fixed? Also, my nose is usually very dry and blocked. Will this make it harder to pass the tube down for the manometry study?
Thank you for your comment and question. We recommend you discuss your question with your gastroenterologist. They can best advise you based on your condition and medical history. If you need a second opinion, our new patient coordinators can assist you in scheduling an appointment at 1-800-BWH-9999.
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