Connect
Esophageal dysmotility
Hello I'm not sure this is where I should ask or not but I need help understanding what all this is telling me and if anyone knows possible treatments or outcomes. I'll give a little bit of history. I've only had what I know as swallowing issues for the last 4-5 months at most. Sometimes I can't even get things to go down into my throat at all, other times I can but whatever it is just gets stuck and that's consistent. I've had chronic heartburn since 2006 ish and been taking Prilosec and or 300mg of Zantac daily since. Which neither of these mess seem to help. But they help better than anything else I've tried. I also have a condition called Ehlers-Danlos syndrome which is a collagen disorder, and I have type 3 (hyper mobile) with mild over lapping of type 4 (vascular). I also have POTs and other autonomic dysfunction. With that being said, I was sent to GI for a consult and so far have had the pudding esophageal motility test, and the Barium swallow X-ray. They have both come back abnormal. The esophageal motility test says:
Esophageal Motility
IMPRESSION: Esophageal transit is normal for water but delayed at mid esophagus for thin and thick semisolid boluses.
FINDINGS: Esophageal transit scintigraphy performed per protocol. Graphic processed scintigraphic display reviewed in addition to the dynamic imaging.
WATER BOLUS: The water bolus passes normally into the stomach within 10 seconds.
BOLUS 1, THIN SEMISOLID: There is hang-up of the thin semisolid bolus in the mid esophagus and at the junction of the mid and lower third, with the tracer in the mid esophagus clearing after 25 seconds and the residual activity in the distal third of the esophagus clearing x 45 s.
BOLUS 2, THICK SEMISOLID: The thick semisolid bolus shows considerable retention in the mid esophagus which predominantly clears after the second dry swallow at 40 seconds.
---
The Barium swallow X-ray says:
Esophagus
Moderate esophageal dysmotility is present with interrupted primary peristaltic wave, intermittent ineffective secondary peristaltic waves which are nonpropulsive. Subsequent peristaltic waves then stripped the barium bolus normally.
There is a small hiatal hernia present with free spontaneous gastroesophageal reflux noted with esophageal distention to the thoracic inlet. There is however no ulceration, stricture, or mass present. Barium pill was administered, which passed freely through the GE junction into the stomach.
---
My Drs impressions says esophageal motility disorder with cervical and esophageal components.
My question is what is this all telling me. I keep looking things up but then get super confused and mixed up. I still have to go back for a upper endoscopy, an esophageal manometry, neuro speech assessment, and a video X-ray barium swallow. I can't find anything on the speech assessment. And I'm not understanding why I have to repeat the barium test? Since medicine isn't working what are some of the treatments or fixes to any of this. Can my esophagus just die? What happens if it stops working all together?
Sorry for the long message. I don't live near Mayo and have to travel to get there so I don't get a lot of time with the drs to ask these questions. They are just more concerned getting the tests done before they make sense of it to me it seems, and I am super lost and confused. Any help would be greatly appreciated
Like
Helpful
HugInterested in more discussions like this? Go to the Digestive Health Support Group.
Connect
I just got over a bout of aspiration pneumonia. 168 antibiotic pills later and I think I'm back to normal. Had a barium swallow and radiologist sent me packing after one film which showed achalasia of the esophagus. My gastroenterologist want me to consider a procedure on the esophagus and I know there are several to be considered but don't know precisely what they are. Have been trying to get an appointment at Mayo's but have not yet succeeded. Any suggestions? We were In MN in June but or unrelated problem
I haven’t posted on Mayo Connect for some time. I had some issues and had a pacemaker put in 5 weeks ago. had some complications, not with the pacemaker but other things. I am still not doing so well. Lately when I get up in the morning I have very excessive saliva, nausea and pain in the chest. Around noon it clears up. What is going on? Has anyone else experienced this? Through all of this I have lost at least 10 pounds and I was already underweight. I have been referred to a gastroenterologist but don’t have an apt yet. Thanks for any info or help you can offer.
Hi @ryman,
I'm sorry to hear about your symptoms. I moved your message to this existing discussion so that you can connect with others talking about esophagus issues. While they may not share the same condition as you, they may have similar experiences with regard to your symptoms of excessive saliva, nausea, and chest pain.
@ryman, have you informed your cardiologist about these symptoms?
No, I haven’t. I was in the ER for over six hours yesterday. They did an EKG and some other tests.
@ryman I have some of these issues, and I have been told I have excessive eosinophilic issue which messes up my entire esophagenic system. I also have Barrett's Esophagus and Stomach cancer.
-
Like -
Helpful -
Hug
1 ReactionThank you for your reply. I have been concerned about Barrett’s esophagus but this extreme has only been for a few days. I have had swallowing problems and esophageal cramps for sometime. I am afraid it may be awhile before I can see the doctor. I wish you well with your problems.
Hi @ryman,
You might also wish to view this discussion, "Non Specific Esophageal Motility Disorder Caused by Beta Blockers" https://connect.mayoclinic.org/discussion/non-specific-esophageal-motility-disorder-caused-by-beta-blockers/ where @tryingtofindanswers has shared some great information.
I have had a hiatal hernia repair and a 360 degree nissen fundoplication to get rid of acid reflux. Post op testing on me was (1). 48 bravo PH test- which indicated that my ph was neutral; (2). esophagram- which indicated that perhaps the wrap is too tight; (3). esophagael manometry- which indicated that my motility was at 30%. Prior to the fundo and hiatal hernia repair i was at 70%- again no reason by the surgeon given for the drop in motility. At 7 months after the fundo operation i had to have my gallbladder removed- it was full of stones. I am still getting "heartburn " sensation. My surgeon has diagnosed this as a "hypersensitive esophagus"- this means that my esophagus pain can be set off by anxiety, stress, etc. The AMA solution for this non-surgically is (1) hypnosis- trick the brain into telling it that my pain is not acid reflux pain- 12 sessions and $1100 out of pocket this has failed; (2) be on antidepressants to relax the esophagus muscles. i am on atavan - 1mg- 4 times a day. I have to take one after i eat a meal to soothe the "heartburn" sensation. it does help a little. Has anyone out there been disgnosed with a "hypersensitive esophagus"? Also has anyone out there who has had a nissen fundoplication have continuing stomach bloating as well as lots of flatulance as i do? My operation was done in pittsburgh,pa on 11/1/2016. I am considering having this undone and just fight off the real heartburn with 60 mg of prevacid as well as 4000 mg of sulcrafate. This worked 1 month before the operation where i had no heartburn. I might also mention that after the gallbladder removal my "heartburn" sensation worsened. When the 48 hr bravo test was done the biopsies performed on the esophagus and stomach indicated some small amount of bile in my stomach. The stomach surgeon thought that the bile may be irritating my stomach and thus irritating the esophagus. he prescribed generic questran, which is an orange flavored resin powder to be dissolved in water before each meal (2grams/meal). After 1.5 weeks of this powder i felt more sick. I checked with the gallbladder surgeon and he said it is not unusual to have some residual bile in the stomach after gallbladder surgeon and many people live with bile in their stomach with no known "heartburn" syndrome. My gastroenterologist says the same thing. The stomach surgeon said to quit taking the questran if it is bothering me. I did quit it. I also noticed after gallbladder removal , i seemed to put on about 7 lbs which has stabilized. Has anyone experienced this after gallbladder removal and Nissen fundoplication? any advice would be greatly appreciated on any of the questions above I would be very interested in anyone who has been diagnosed with "hypersensitive esophagus...thank you.....kozlo52
Hello @tryingtofindanswers
It has been a while since you have posted about your motility problem. I hope that you have found some help by now.
We would like to hear from you. Will you let us know how you are doing?
Teresa
-
Like -
Helpful -
Hug
2 ReactionsHi @kozlo52,
I'm tagging Mentor @kdubois, as she may be able to help answer some of your questions.
You may also be interested in reading this discussion, https://connect.mayoclinic.org/discussion/does-anyone-here-have-or-heard-of-nutcracker-esophagus/ where @blackoutthesun @maureercria have written about Nutcracker esophagus, which is similar to esophageal hypersensitivity.
-
Like -
Helpful -
Hug
1 Reaction