Motility Disorders: Digestive Diagnostics

Questions? Call
Appointments by referral only.

Your gastrointestinal (GI) system digests and moves food through your body. GI motility refers to the pace and ease of that food movement. Disease, injury, infection, and other motility disorders can slow down or speed up your food’s journey.

Signs of a Motility Disorder

You might have a motility issue if you have:

  • Severe constipation
  • Recurrent vomiting or regurgitation
  • Bloating
  • Diarrhea
  • Nausea
  • Weight loss
  • Pain or problems swallowing
  • Heartburn or GERD

If you have any continual problems in your throat, chest, stomach, or bowels, talk to your doctor or provider. You may need a motility test. At UVA, you’ll find a team that’s skillful, knowledgeable, and helpful. We use the latest tools to give you personalized care.

What to Expect from a Motility Test

Generally, motility diagnostic tests:

  • Don’t hurt, though they may cause discomfort
  • May use medicine to numb your throat
  • Produce results in 10 days

At the test, you’ll need to provide your doctor with information that will help us give you the right treatment.

Medication can treat some motility issues. Sometimes, we can offer surgery and physical therapy as an option.

Types of Motility Disorders

Motility disorders can happen at different points in your GI system. We usually find issues in the:

  • Esophagus
  • Stomach
  • Small intestine/colon
  • Pelvic floor

Our motility team uses sophisticated tools to pinpoint or at least get insight into the source of the problem.

Motility Issues in the Esophagus

Trouble swallowing, acid reflux, or throat or chest pain can mean you have motility problems in your esophagus.

Acid Levels

If you have GERD, we can test and monitor acidity, or pH, in the esophagus. These tests allow us to measure acid levels accurately.

Esophageal 48-Hour pH Monitoring

This test evaluates if and how acid from the stomach is refluxing into your esophagus. We attach a small device onto the esophageal wall. We do this during an upper endoscopy. Over 2 days, the device measures the frequency and duration of acid going up into your esophagus.

Esophageal 24-Hour pH Monitoring

We use this test to measure the amount of reflux (both acidic and non-acidic) in your esophagus during a 24-hour period. We can use the results to see the relationship between your symptoms and the reflux.

To perform this test, we place a catheter, about the size and flexibility of a smartphone power cord, through your nose. You then drink water to move the catheter into your esophagus. We tape the other end of the catheter to your cheek and wrap it over your ear. A small data recorder attached at the end will monitor your acid reflux for a 24-hour period.

Esophageal Manometry  

This test measures the function of your esophagus muscles. It uses a thin, flexible tube with many sensors. We place this tube through your nose, down your throat, and into your esophagus. We then measure your ability to swallow a spoonful of water every 30 seconds.

Our specially-trained motility nurses are highly skilled at placing these tubes and ensure patients have the most comfortable experience possible.

Possible causes of your esophagus issues include:

  • Achalasia
  • Barrett’s esophagus
  • Esophageal diverticula
  • Eosinophilic esophagitis
  • Diffuse esophageal spasm
  • Gastroesophageal reflux disease (GERD)
  • Hiatal hernia
  • Hypertensive peristalsis (previously known as Nutcracker esophagus)
  • Para-esophageal hernia
  • Pseudo achalasia
  • Scleroderma

Motility in Your Small Intestine

Breath Test

We offer breath tests to evaluate for carbohydrate malabsorption. This means your body doesn’t absorb sugars and starches like it should. The result: cramps, pain, diahhrea, flatulence, headaches.

Breath tests can also see if you have small intestinal bacterial overgrowth.

Video-Capsule Endoscopy

For this test, you'll swallow a pill-sized camera. This device will take photos from the inside of your small intestines. We use the images to find the source of bleeding or to diagnose Crohn's disease.

Motility in Your Stomach

Several motility disorders can happen in the stomach. Our team uses a wireless, pill-sized camera. This tiny device records changes in temperature, pressure, and acid levels in your GI tract. We measure how long it takes the capsule to move through your system.

This exam can show the cause of:

  • Irritable bowel syndrome (IBS)
  • Constipation
  • Gastroparesis or delayed gastric emptying
  • Rapid gastric emptying (dumping syndrome)
  • Idiopathic vomiting
  • Functional dyspepsia
  • Cyclic vomiting syndrome

Make sure to talk to your insurance provider about what your plan covers before choosing capsule endoscopy.

Motility in Your Colon

Motility disorders that can happen in your colon or large intestine include:

  • Intestinal pseudo-obstruction
  • Colonic inertia
  • Scleroderma
  • Irritable bowel syndrome
  • Megacolon

Motility in Your Pelvic Floor

The muscles of your pelvic floor hold together your bladder, bowels, and rectum. If you’re female, they support your uterus and vagina, too.

A weak or injured pelvic floor can cause:

  • Pressure or pain in the rectum
  • Muscle spasms in the pelvic region
  • Incomplete bowel movements
  • Pain during bowel movements
  • An urgent need to move your bowels
  • Fecal incontinence
  • Constipation
  • Leaking
  • Levator ani syndrome, anal pain from tight muscles

Testing the nerve or muscle function in your pelvic floor area can show us where and why you’re having symptoms. We look for coordination and strength of the pelvic floor.

We use anorectal manometry to measure the strength and nerve response of your pelvic floor. This involves a thin, flexible tube with sensors. The balloon expulsion test identifies problems with having a bowel movement. 

Our motility nurse specialists have the skill and training to make this experience as comfortable as possible.

Pelvic Floor Physical Therapist

If you have a pelvic floor weakness, we can connect you to pelvic floor physical therapy to strengthen pelvic floor muscles. Learn more about our services for pelvic floor disorders.