Causes and Diagnoses

Causes and Diagnoses of Spastic Esophageal Motility Disorder

The cause of spastic EMD is not known. Experts believe it is related to an abnormality of the nerves that control peristalsis.

Risk factors that increase your odds of experiencing spastic EMD include:
  • High blood pressure
  • Anxiety
  • Depression
  • Red wine
  • Eating extremely hot or very cold food

Diagnosing Spastic Esophageal Motility Disorder

Diagnosis of EMD may require a test to measure the pressure within the esophagus as you swallow or the use of an endoscope (a thin tube with a camera at the end of it) to examine the lining of your esophagus. Your physician will consult with you about determining the type of EMD you may have and how best to treat it. Other diagnostic tests may include:

  • Upper endoscopy: Your physician will lightly sedate you and may numb your throat before sliding an endoscope down your throat. This tiny camera lets the physician see the surface of your esophagus. The physician may, if necessary, perform a biopsy (obtain small tissue samples) by using forceps (tiny tweezers) that are passed through the endoscope. A pathologist will examine the sample to determine if the tissues are abnormal.
  • Esophogram/barium swallow: A special series of X-rays is taken of your esophagus after you drink small amounts of a liquid containing barium, a contrast material that coats your esophagus and shows up well on X-rays.
  • Pharyngeal manometry: A pressure-sensitive tube is passed through your nose and into your stomach to measure pressure inside your esophagus.
  • pH monitoring: A nasogastric tube is passed through your nose into the lower esophagus for 24 to 48 hours to monitors how and when acid enters the esophagus. If used in conjunction with a food diary (a log indicating the amounts and types of food eaten at specific times), this allows your physician to find a correlation between symptoms and reflux. This test may be used to determine whether respiratory symptoms are caused by reflux.
  • Esophageal impedance test: Using a catheter, this test measures gas or liquids that reflux into the esophagus. It is useful in helping assess regurgitation of non-acidic substances.