Manometry test back - Ineffective Esophageal Motility

Hi all,

I have recently found out I had GERD in the last 6 months, had symptoms for 3-4 years now but always thought it was sinuses (mucus throat, sore throat, globus sensation). Woke up one morning with trouble swallowing in throat and it hasn't gone away since. I'm currently on PPIs X2 and Bethanechol. Had endoscopy and showed irritation, couple shallow ulcers that healed and a small piece of Barretts esophagus (1 mm).

Recently went for manometry and 24 hr PH Test. Haven't got the PH Test back yet, but manometry showed I failed 8/10 swallows, with only 2 being peristaltic and the other 8 having very low contraction amplitude. Dr said this is most ineffective esophageal motility disorder. Dr thinks that this is why I'm having trouble swallowing, but I'm hoping that since I still have GERD symptoms that it is more so that.

Anyone else has findings similar that can give advice? I'm hoping that some type of fundoplication/partial fundoplication and getting rid of acid could help motility.

Linda Sue,

Jackhammer esophagus is pain from hypercontractive peristalis, where as I have hypocontractive peristalsis (muscles are too weak, rather than too strong). I don't have any major pain, just trouble swallowing in my throat, hoarseness, sore throat, etc.

I also have severe dysphagia. Back in December of last year I developed a terrible cough for almost 3 months. It went away eventually, but then in March I developed severe reflux. Both heartburn and throat burning. It was quite terrible. For years prior to this I did have some sort of swallowing problem, as I had to eat everything with water, but it was tolerable. As the months went by with this crazy heartburn, I started having more and more problems swallowing. The Doc put me on 2X Protonix for the reflux. It's been over a year now. The reflux is mostly under control, but I'm still having trouble swallowing with both food and liquids. A manometry showed severe dysphagia. My doctor recommended agains the LINX procedure because it could make my swallowing worst. He didn't bring up anything about the Fundo. This was a few months back. I did feel that the swallowing was improving a bit over the last few months, but now I don't know, because I just had a swallowing study done and I noticed a lot of times some water will remain near the opening of my air tube, and I'll have to swallow again to get it down. I also overheard the radiologist say "no peristalisis" but hopefully it's not what I thought I heard. Still need to meet with the doc for results. It's been causing me much anxiety. I haven't reallly gotten the answers I've been looking for. I think allergies and post nasal drip are contributing to the problem. I hope your problem is doing better. I'm going to continue losing weight to see if that helps with the reflux.

Post Edited (brianissleepy) : 5/30/2018 5:38:57 PM (GMT-6)

I have been advised Eosophageal manometry and 24 hour pH metry tests. I am unable to find the costs of these tests by googling. I am from India. Any guidance in this regard is much appreciated.

Brian:

I started to suffer from nutcracker esophageal spasms 7 years ago: really horrible chest pain that I am told equal to the pain level of a heart attack, which I totally believe. 2 years ago, I began to have swallowing problems that progressed to the point of being unable to swallow solids. I would wake up in the middle of the night coughing from aspiration of liquid into my lungs.

I began to research the problem on the internet and obtained good information regarding these issues from published studies with the National Institute of Health, Cleveland Clinic, John Hopkins, Mayo. My research indicated that it could be any variety of issues and that I needed to find a specialist GI doc that focused on diseases of the esophagus, not just a general GI.

In 2017, I located a doctor that focused on these diseases at University of Texas Southwestern. I cannot emphasize how important it is to find a GI with a focus on esophageal disorders. The Doctor listened and immediately ordered tests. She conducted these tests over a period of a year, including two EGDs with dilations, barium swallow and the dreaded manometry pressure test. I was diagnosed with Achalasia, a rare condition where my nerves in the esophagus are damaged and cause the muscle to no longer relax to allow food to pass into my stomach. To stop the damage of the pressure of the food trying to pass through the clenched muscle, we decided on the gold standard operation, Laparoscopic Heller Myotomy with a partial DOR wrap of the stomach.

I am currently 3 weeks post surgery. The surgeon cut my esophagus to allow the food to pass and gave me a DOR wrap on my stomach to prevent GERD. So far, although I still have a little difficulty swallowing, it is getting better and I do not have any GERD. Quality of life has definitely improved. The jury is still out on the spasms, but it is my understanding that I have 50/50 odds of the surgery improving them based on a NIH study by medical experts. So, we will figure that out.

Researching and finding a specialist helped me get a diagnosis quickly. I wish you the best of luck.

harrisp said...
Hi all,

I have recently found out I had GERD in the last 6 months, had symptoms for 3-4 years now but always thought it was sinuses (mucus throat, sore throat, globus sensation). Woke up one morning with trouble swallowing in throat and it hasn't gone away since. I'm currently on PPIs X2 and Bethanechol. Had endoscopy and showed irritation, couple shallow ulcers that healed and a small piece of Barretts esophagus (1 mm).

Recently went for manometry and 24 hr PH Test. Haven't got the PH Test back yet, but manometry showed I failed 8/10 swallows, with only 2 being peristaltic and the other 8 having very low contraction amplitude. Dr said this is most ineffective esophageal motility disorder. Dr thinks that this is why I'm having trouble swallowing, but I'm hoping that since I still have GERD symptoms that it is more so that.

Anyone else has findings similar that can give advice? I'm hoping that some type of fundoplication/partial fundoplication and getting rid of acid could help motility.

Hello. I have a similar situation as you. How are you doing these days? Looks like this was posted 2 yrs ago