Esophageal motility disorder is a condition where the muscles in the esophagus don’t move in a coordinated way or are too weak, causing difficulty swallowing and regurgitation of food and drink. There are several types, including primary and secondary, with achalasia being the most understood. Treatment is based on easing symptoms, such as eating more slowly and carefully, medication, or surgery.
The esophagus is the tube that carries food and drink from the mouth to the stomach. Normally, the muscles in the walls of the esophagus contract in a coordinated way to move solids and liquids. Esophageal motility disorder is a condition in which the muscles don’t move in a coordinated way or are too weak. This means that the esophagus is unable to push substances into the stomach effectively. Someone with esophageal motility disorder may experience symptoms such as pain, difficulty swallowing, and regurgitation of food and drink.
There are several types of esophageal motility disorder. Primary esophageal motility disorders, or PEMD, are major diseases, occurring on their own, while secondary esophageal motility disorders occur as a result of other diseases. Esophageal dysmotility tends to be a long-term problem, lasting for months or years, and symptoms vary depending on the specific type of disease. For many forms of the disorder, the causes are not fully understood.
Achalasia is probably the best understood type of esophageal motility disorder. It is thought to be caused by the loss of nerve cells within the muscles in the esophageal walls. Over a number of years, a person with achalasia gradually finds it more difficult to swallow food and drink. Sometimes food is regurgitated and there may be chest pain behind the breastbone. Achalasia usually begins to develop between the ages of 20 and 60 and can result in weight loss.
In what are known as spastic esophageal motility disorders, the esophageal muscles contract abnormally, causing chest pain, which is sometimes accompanied by difficulty swallowing. Swallowing is usually not as severely affected as in achalasia. Chest pain associated with spastic esophageal motility disorder may be confused with pain from heart disease. It sometimes occurs during exercise and may involve emergency hospital visits. Spastic esophageal motility disorders are not as well understood as achalasia, and the causes of the abnormal muscle contractions in the esophagus are unknown.
Because esophageal motility disorder cannot be cured. Treatment is usually based on easing symptoms if they become too severe. Simple measures can help, such as eating more slowly and carefully, eating smaller meals more frequently, and avoiding lying down or exercising after eating. Medications may be used to relax the esophageal muscles, or a type of balloon may be inflated inside the esophagus to widen it. Sometimes surgical techniques are used to cut some of the muscles, allowing food to pass through more easily.
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