Esophageal dysmotility

Posted by Brie @brie87144, Mar 17, 2017

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.
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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.
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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

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Profile picture for dadsruby8g @dadsruby8g

I was put on a liquid diet after an Esophageal Dilation and I totally understand the frustration of trying to find things to eat. I found potatoes and sweet potatoes to be a good option. I just made sure they were whipped up to a light consistency with no lumps.
I added plenty of milk to regular potatoes and can also make them into a creamy soup.
With the sweet potatoes, I added a little butter and brown
sugar (of course) and made sure to "smooth out in my mouth" when eating to strain out any stringy fibers of the potato.

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Thank you

Sent from the all new AOL app for iOS

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Profile picture for nicole0325 @nicole0325

I have had acid reflux and indigestion problems for years. I’ve seen a gastroenterologist for years as well.

I have a genetic problem that I have to go to University of Iowa hospitals, for that is called Ehlers Danlos syndrome. I have a hyper mobility of joints, which there is no cure, but I have along with that a connective tissue disorder, which affects my collagen and healing

I have for the last couple years, felt different as if stuff was getting stuck at the bottom of my back of my throat or bottom of my neck. I would still go to bed a couple hours after I’ve had supper, and would be inclined, and still regurgitate. I can drink liquid and still bend over shortly after and it comes back up.

I have met with the surgeon at the University of Iowa hospitals, and he explained with my issue and having Ehlers-Danlos Syndrome that my risks would outweigh my benefits, and I could be worse off. He said because of my connective tissue disorder that collagen issue would allow me to not heal. I also had an emergency splenectomy years ago and he said I would probably have quite a bit of scar tissue inside, which would be difficult as well to do the surgery. In August I am going to have a device put on my esophagus and I have to wear it for 48 hours to measure the acid in my stomach. He said if that measures extremely high, he may rethink surgery.

After all of this, I’ve said, I guess I’m just wondering what kind of stuff I can eat. I have been drinking meal replacement shakes for the most part. I can eat salad because it’s not hard and crunchy. I eat yogurt. Otherwise I might as well forget meat, and bread of any sort.

If anyone has any ideas of a diet or food that I could eat, please let me know.

Thank you so much

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-kefir
-various soup broths (strain out the solids—at least their nutrients will be in the broth)
-liver paste
-fish paste
-green juices
-healthy smoothies
-mashed squash & sweet potato

A friend of mine bought a recipe book for dysphasia (did I spell that right?) off Amazon, but I haven’t reviewed it yet

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Profile picture for Cam @tryingtofindanswers

Hi I’m a 39 year old woman and I’ve got ineffective esophageal motility disorder, with spasms. My manometry showed 90% failed swallows. I can eat certain things like liquid drinks, smoothies, puréed soups and some solid foods like meltable solids such as shortbread cookies, cheetoh puffs, crackers,frozen yogurt, yogurt and basically anything you can give a baby. My doctors have told me there’s nothing they can do for me, that I’ve got to learn to deal and a nutritionist won’t be helpful. Ugh. They’ve been zero help. All they did was put me on Omeprazole and say it won’t get better and just hope it doesn’t get worse. So I’m looking for food ideas from others with this issue. I think from googling on my own I’ve realized maybe I can do mechanical soft, but I’m scared as when this began my swallow reflex would stop when something solid would get stuck and I don’t want to go backwards since I have to work full time and maintain my energy. I’ve been suffering with this for two years and lost a violent amount Of weight at first, so much so that my gall bladder went bad and had it removed in June. Ugh. It’s so hard “living” like this and these food holidays don’t help. Ugh. I’m tired of feeding my body liquid sugar and junk food because it goes down easy. I wish I could just bake a chicken breast and some broccoli. I’ve tried pureeing my food but I wanna vomit with puréed meat. Ugh. Any assistance with ideas for more solid/soft food that goes down for those with esophageal motility disorders would be beyond appreciated. Thank you.

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I suffer from aperastalsis of the esophagus as well as achalasia. Ive had a Heller Myotomy but unfortunately I still have issues. My issues is violent burping and hiccuping most of the day and vomiting part of every meal I eat. I even vomit water. Ive been on every type of medication you can think of including anti-anxiety and anti-depressants. Nothing worked. Does anyone else suffer from vomiting. I actually went to Minnesota to the Mayo Clinic and was advised I may have a mental condition that is causing me to swallow air. I was advised to see a therapist and practice diaphragmatic breathing

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Has anyone had the Stretta procedure and have comments to share. I am considering it due to my troublesome LPR. Would appreciate any input. Thanks!
Frank M.

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Best of luck in your findings. I have the same issues with my esophagus and they say it's non MOTILITY disorder ok now how do I fix the problem. I have lost over 75 lbs in the last Three years and still loosing weight as we speak taken every drug that mankind had made and still can not hold my food down. I haven't eaten a good meal In years at times I want to give up on life. But as I said earlier good luck and if you do find that miracle doctor please let me know. Stay encouraged.

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Profile picture for hikeema123 @hikeema123

Best of luck in your findings. I have the same issues with my esophagus and they say it's non MOTILITY disorder ok now how do I fix the problem. I have lost over 75 lbs in the last Three years and still loosing weight as we speak taken every drug that mankind had made and still can not hold my food down. I haven't eaten a good meal In years at times I want to give up on life. But as I said earlier good luck and if you do find that miracle doctor please let me know. Stay encouraged.

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So sorry to hear that you are as miserable as I was a few years ago…
Bloated stomach, like 8 months pregnant, an hour after every meal. No matter how tiny it was. Gastro doc did no tests except barium swallow which was ok, and told me to follow the FODMAP diet, no other info. 😱
Reached a point where swallowing sounds like your horrible issues.
I went to a local health supplement store, (not chain-but probably a chain might be able to help you,) and told them my problems after I couldn’t eat and I’d lost about 10 pounds in about 3 weeks. I was dizzy and didn’t feel really that safe driving. They recommended a
“porcine enzyme” (pig) to help with digestion. Surprised. I was desperate and took them. Amazingly, it worked!
If I remember, capsules and powder, capsules could be opened and mixed with water, etc.
Scheduled visit with Gastro and brought them with me to show him what helped. Anyway, he looked at them and said there were better things than this(?)Then he walked out…
Stunned, that was the motivation to move on.
Got an appt with new Gastro and had 4 tests within 2 weeks. And an upper endoscopy
1 week after that.
I had SIBO, (diet and expensive medication to fix;) bellybutton hernia, hiatal hernia, acid reflux, and my esophagus was tight and he stretched it when did the endoscopy. Not painful after.
I also have severe scoliosis, don’t notice it, thank the Lord, and that can also be pressing on my esophagus. I’ve had the stretching a couple times, and sort of an instant fix for swallowing.
I take famotidine, 20mg, down from 40.
It’s hard work to get things in order, and it took a couple years to really get the concept of “small meals”, after 3 meals a day, my whole life. Learned that a meal can really be just a tasty snack.
Of course, you may not have any of these things, but the porcine enzyme and the stretching helped me reach a point where I could work on the rest…

Maybe a new doctor?

Good luck!

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Profile picture for kaykay729 @kaykay729

The SIBO diagnosis was found with a boost on the small intestine during an EGD. I don't disagree with that diagnosis but I don't have the symptoms like I read about other people having. Now I am diagnosed with Ineffective Esophageal Motility with the doctor telling me nothing can be done about it. I would like to find other people that have this so I can understand how to eat and maintain caloric intake and in fact if it's true that nothing can be done.

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Did you receive the diagnosis at the Mayo Clinic? I have Ineffectual Esophageal Motility as well. Severe spasms that last for hours and told there is nothing they can do for me as I have to learn how to live with it. 3 opinions in NYC. Tried nitroglycerin, channel blockers and domperidone and nothing works for me. I'm asking if you were seen at the Mayo Clinic and they told you there is nothing they can do because I was thinking about making an appointment with them and the cost for air, hotel etc. is high so I want to ensure there is a possibility of help.
Thank you.

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Profile picture for Cam @tryingtofindanswers

I've been dealing with swallowing issues for over a year and a half now. They began after a course of beta blockers. After two manometry tests, 3 barium swallows and two endoscopies, i've been diagnosed with ineffective esophageal motility disorder and a sliding hiatal hernia. I also have pretty bad acid reflux. I have trouble eating anything that isn't liquid now. The only solids I can eat are saltine crackers, graham crackers and shortbread cookies, basically anything that's a meltable solid. As part of this issue, i get what feels like random electric shock sensations over my chest. They are quick and usually are a result of how I'm sitting or something I've eaten that's more solid. My heart has been ruled out, so these sensations are coming from the esophagus, i assume. Has anyone experienced this sensation as part of esophageal motility issues or hiatal hernia? Also, just doing another random check-in to see if anyone has ever been successfully treated for esophageal motility disorders. I sure do miss the luxury of solid food. Curious as to what doctors at mayo are good to see about esophageal motility disorders that are not achalasia. Thanks!

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I’ve had 3 opinions to find out what is causing my randim chest pains. I also have a recurring hiatal hernia. Thev3rd doc thinks I mifht have esophageal spasms. I need more tests, but he said it could mean surgery, meds, or both. Some people get telief from Alroids mints! Natural peppermint is a natural muscle relaxer. So while I wait for more tests, I am going to keep a tin of altoids by my bed. It can’t hurt. I will be following. Good luck. This is painful and frustrating.

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Profile picture for warrendog @warrendog

I’ve had 3 opinions to find out what is causing my randim chest pains. I also have a recurring hiatal hernia. Thev3rd doc thinks I mifht have esophageal spasms. I need more tests, but he said it could mean surgery, meds, or both. Some people get telief from Alroids mints! Natural peppermint is a natural muscle relaxer. So while I wait for more tests, I am going to keep a tin of altoids by my bed. It can’t hurt. I will be following. Good luck. This is painful and frustrating.

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Good luck to you. Hope you find some relief.

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Checking around to get best foods for my mom to eat. She has esophagus issues, hernia in chest and reflux. Will be returning to gastroenterologist soon. I try to encourage her to make good food choices, but she doesn’t really listen. I’d like to provide her the foods or beverages that will help, not hurt. She hasn’t lost any weight.

By the way, is popcorn a good option? I wouldn’t think it was a good choice, but she likes it.

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