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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.
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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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Just diagnosed, may 2024. Do not know no one with this disease. I am sad, confused and desperate because of the symptoms. I confused them with heart issues. Had visit the ER a few times now. Can someone help me out with? Give some orientation
I’m sorry you’re dealing with this. I too was diagnosed two months ago. I end up in er once a week with chest pain. My drs said I have irregular muscles I my esophagus. Discovered on my go motility test. They are trying meds to relax muscles so eating and swallowing are easier. I also have eliminated acidic food. Strawberries apples etc. it’s really helping more than the meds. I had to change my diet completely. There is light at the end of the tunnel.
I take 20 mg of amitriptyline. Some people take 50 and it works. There are other meds out there.
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2 ReactionsI take 3, piridostigmina, buspar and prevacid. I hate so much meds. Does not work that good. Any chest pain and feelings that your heart is jumping stomach area. I have confused my heart with IEM symptoms. Awwfull feeling
HI
it happens to me too. started a year ago, but i have the same sensations. i am taking buspar, prevavicd pepcid and used to have pyridostgimina, now of because it cause me arrithmyas.
Go see Dr. Bowers at Jacksonville Mayo..........Do it!!!!
Nissen fundoplication, I know there is a problem with mine but with Lupus it will remain. I have Barrett's 3 levels in different places. They might have been worse without the Nissen fundoplication??
Slow motility but no sudden drops. Learning what to eat is a process.
I was trying soft fruits but to much sugar for autoimmune has parked me right now.
Food is not my friend.
So many here have such serious issues, I count my gratitudes.
GI in a medical school environment. Some are just fastest $$ from 15 min endoscope and colonoscopy. Not for anyone on this site.
Hello - I also have a g tube because of dysphagia brought on by treatment of cancer in my mouth. How are you removing saliva from your mouth? I use a water pic and rinse with mouth wash but since I can' open my mouth it is an ongoing struggle. Thank you for any suggestions you might have.
One doc said achalasia, and another said 'AC - absent constictivity.
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