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Forum Name: Gastroenterology Topics

Question: Esophagus Motility???


 ice4me - Wed Jan 05, 2005 12:49 pm

I have a question. I no longer smoke and when I did I rarley rarely smoked but one day (and since that day) when I smoked I experienced a feeling of smoke trapped in my chest. And let me say before I go any further, I have seen a couple of gastroenterologist for this problem but no diagnosis. I think the reason is because this is very rare and not normal at all. Anyways ... so when I felt that smoke trapped in my chest area, it made me feel really bad. And I would have to knock on my chest because I felt a strong need to burp it out. Suprisingly when ever I did belch (which was very hard to do) I could see smoke come out. I get that same feeling of something stuck right above my diaphragm area sometimes when I eat and take medication and I also feel the need to regurgitate or belch. Im 150% sure something isnt right with my body but I just don't know what else to do. I feel like Im the only one whos really concerned about my problem. I've already had an Upper Endoscopy and a barium X-ray. I beielve its something extremely rare thats why those test didnt find anything. Would you have any suggestions for me? Thanks
 Dr. Safaa Mahmoud - Wed Jun 21, 2006 2:49 am

User avatar Dear ice4me,
Active oesophageal motility and regulated peristalsis is the mechanism by whish food moves from the proximal end of the oesophagus down to the stomach. At the same time sphincter control in the upper end of the oesophagus (UES) prevents air entry into the GI tract during inspiration, while the lower oesophageal sphincter (LES) prevents the reflux of food and acids from the stomach back into the oesophagus.
Disorders in Esophageal motility ranges from well defined causes like Achalasia in which the lower oesophageal sphincter fails to relax leading to accumulations of food at the distal end of the esophaus, to non specific motility disorders. They are also classified into Primary spastic esophageal motility disorders which means that the esophageal body itself is where the disease is intiated, and Secondary motility disorders in which, the affection of the esophagus is cuased by a systemic disease.
In some cases, a simple chest or esophagraph can aid in the diagnosis especially when the lower end of the esophagus is dilated. Endoscopy is of choice to exclude mechanical and inflammatory causes. However, endoscopy is not a sensitive technique if primary esophageal motility abnormalities is suspected. In that case, Manometric studies can help evaluate the esophageal motor activity and LES function. Ambulatory esophageal manometry, although remains investigational, it can record esophageal pressures over longer periods of time aiming to catch any pressure changes in association with symptoms.
If your symptoms are frequent and making you feel sick, you better keep your self on regular follow-up with your physician and see what are the other investigations that can be done to reach the proper diagnosis hence, the specific medical care.
Good luck,

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