An esophageal motility disorder (EMD) is a disorder of the esophagus that may cause swallowing difficulties, spasms of pain or regurgitation of food. The Motility Diagnostic Lab, also part of the Digestive Health Center, is where you can be seen for the diagnosis and treatment of EMDs, including:

• Spastic EMDs – These disorders cause the esophageal muscles to contract and expand abnormally. This can cause pain and difficulty swallowing. Spastic EMDs include:
• Achalasia – This disorder prevents the sphincter connecting your stomach and your esophagus from relaxing. This makes it difficult to swallow solid foods or even liquids. Common symptoms include chest pain, heartburn and regurgitation of food.
• Diffuse esophageal spasm – An uncoordinated muscle spasm in the esophagus causes difficulty in sending food to your stomach. This can also cause chest pain.
• Nutcracker esophagus – Strong muscle spasms cause noncardiac chest pain and occasionally difficulty swallowing, even though they are coordinated.
• Hypertensive lower esophageal sphincter – The sphincter between your esophagus and your stomach is contracted, causing difficulty swallowing, chest pain, heartburn and regurgitation.
• Esophageal scleroderma – This is an autoimmune disorder where your body attacks itself, causing scarring and thickening of the esophagus tissues. It causes the smooth muscle of your esophagus to function abnormally.

The Motility Diagnostic Lab offers diagnostic testing for EMDs, which includes:

• High-resolution manometry – A catheter is inserted into your nose and placed into your esophagus. Sensors throughout the catheter show patterns in the motility of your esophagus, which are interpreted by our experts. This is one of the main ways we diagnose EMDs.
• Functional luminal imaging probe (FLIP) – This study is performed during an endoscopy. A small measuring tool is deployed to assess the ability of your esophagus to swell from pressure from the inside (distensibility). This is another main way we diagnose EMDs.

The Northwestern Medicine Digestive Health Center offers these diagnostic tools for EMDs:

• Timed barium swallow esophagram – You will swallow thin barium, a contrast material that coats your esophagus and shows up well on X-rays. A series of X-rays are taken at 1, 2 and 5 minutes to determine if the barium is being retained.
• Oropharyngeal motility (swallowing) study – You will be given small amounts of a liquid containing barium to drink with a bottle, spoon or cup. A series of X-rays is taken to evaluate what happens as you swallow the liquid.