With every bit of food that goes into their mouth, your child’s digestive tract is hard at work.
The digestive tract includes four parts: esophagus, stomach, small intestine, and large intestine. Gastrointestinal motility is the movement of food through this tract, from the time food enters the mouth through when it’s eliminated from the body. All four parts of the tract work together to make sure food is fully digested and leaves the body.
But if there is a problem with the nerves, muscles, connective tissue, or structures within any of the four parts of your child’s digestive tract, they may develop symptoms of a motility disorder.
The Motility Disorders Program at Children’s Hospital & Medical Center provides services and treatments for children with many types of motility problems.
What Sets Children’s Apart?
Children’s Hospital & Medical Center’s Motility Disorders Program is the only pediatric program in the region to offer the full spectrum of testing and care for motility disorders.
Motility Disorders Program providers work hand-in-hand with their colleagues in the colorectal surgery, ENT, and urology departments — making them uniquely qualified to care for patients with complex disorders.
Conditions We Treat
We provide care for children with a number of conditions, including:
Anorectal Malformations (Imperforate Anus)A birth defect where the anus — the opening to the rectum — is missing or blocked, which leaves no opening for stool to pass through.
Colonic DysmotilityAbnormal contractions of the muscles in the colon (large intestine), leading to problems such as diarrhea, constipation, cramping, and irritable bowel syndrome (IBS).
DysphagiaDifficulty or pain while swallowing, which makes it a challenge to eat and get enough fluids and calories to nourish the body.
Esophageal AchalasiaA disorder where the esophagus — the tube that brings food to the stomach from the throat — is impaired, making it difficult for food to move into the stomach.
GastroparesisThe stomach can’t contract the way it should, which reduces the stomach’s ability to empty food. Gastroparesis is a common complication in people with diabetes.
Hirschsprung DiseaseA birth defect where there are nerves missing at the end of the bowel, preventing stool from moving through the bowel normally and creating blockages.
Intractable Constipation and EncopresisConstipation (3 or fewer bowel movements in a week) is intractable if it doesn’t respond to the usual treatments, such as changes in diet or physician-prescribed laxatives. Children who are chronically constipated may experience encopresis, which is when they pass stool into their underwear or pajamas far past potty-training.
Pseudo-obstructionThere are symptoms of a blockage in the intestine (bowels) — such as bloating, constipation, belly pain, and weight loss — but the symptoms are caused by muscle or nerve problems that keep food from moving through the intestines properly rather than by an actual physical blockage.
RuminationUndigested food is regurgitated (brought back from the stomach to the mouth) for no apparent physical reason, and some children may rechew and re-swallow it.
The Motility Disorders Program provides specialized motility testing and treatments, including:
Manometry TestingManometry measures pressure in different parts of the digestive tract in order to see how well the parts are working. Your child’s physician may order:
- Antroduodenal manometry, which tests the muscles of the antrum (lower part of the stomach, which prepares food to enter the small intestine) and the duodenum (the first part of the small intestine, which receives food)
- Anorectal manometry, which tests if your child has normal sensation and is using their muscles to hold and pass stool as they should
- Colonic manometry, which tests the function of the colon (large intestine) and sees how well the colon stores and eliminates waste
- Esophageal manometry, which tests the function of the esophagus — the tube that brings food to the stomach from the throat
Esophageal Impedance and pH Probe StudiesEsophageal impedance and pH probe studies measure acid levels in your child’s stomach and esophagus (the tube that brings food to the stomach from the throat) to see if acid is coming up from the stomach. This study may be used if your child has suspected gastroesophageal reflux disease (GERD) or acid reflux.
Esophageal Botox® Injections and DilationBotulinum toxin (known as Botox®) can be injected into the esophagus (the tube that brings food to the stomach from the throat) in order to relax the muscles and make it easier to swallow. Dilation is a non-surgical technique that widens the opening where food enters the stomach.
Your child’s provider may recommend these treatments for esophageal achalasia.
Pyloric Botox® Injections and DilationThe pyloric sphincter is a ring of muscles that helps control food being passed from the stomach into the small intestine. Spasms in the pyloric sphincter can contribute to gastroparesis, where the passage of food is slowed or completely stopped. Injections of botulinum toxin (known as Botox®) into the pyloric sphincter can relax the sphincter and allow more food to pass.
Dilation is a non-surgical technique that widens the opening where food enters the small intestine.
Anal Botox® Injections and DilationThe anal sphincter is a group of muscles at the end of the rectum that surrounds the anus and controls the release of stool, maintaining continence. There are two sphincter muscles: one is internal and one is external. Botox injection into the anal sphincters can relax the sphincters and allow stool to pass more easily. Anal Botox® is used in children with Hirschsprung disease, severe functional constipation, and internal anal sphincter achalasia. Dilation is a non-surgical technique that widens the anal opening to allow easier passage of stool used in patients with anal stenosis or after Hirschsprung surgery.
Long Term Management of Patients with Chronic Motility Disorders
Some motility disorders can be completely cured with treatment. Others, however, may require long-term care. Our providers offer continued care for your child as they grow and help them manage symptoms.
Learn about additional gastroenterology services at Children’s.
What To Do Next
Make An Appointment
To make an appointment, call 402-955-5700.
For Referring Providers
The Physicians’ Priority Line is your 24-hour link to pediatric specialists at Children’s for emergency and urgent consults, physician-to-physician consults, admissions, and transport services. Call 855-850-KIDS (5437).
Learn more about referring patients.