The Center for Motility and Neurogastroenterology is committed to improving the health of patients affected by motility disorders. Our physicians and faculty, recognized around the world as experts in their fields, bring highly specialized knowledge and training to these problems.
Disorders related to gastrointestinal motility (the movement of food contents through the GI tract) and gastric acid production are among the most common problems in the field of Gastroenterology and indeed, in all of medicine.
The stomach makes liters of highly acidic juices daily. This fluid, which is thousands of times more acidic than blood, plays an important role in digestion and in normal defenses against infection. Symptoms arise when gastric secretions are too acidic, not acidic enough, or not moved properly through the GI tract. Heartburn, pain in the upper abdomen, difficulty swallowing, nausea, vomiting, belching, and an acidic or unusual taste in the mouth can all be symptoms of acid-related disorders.
The GI tract is also responsible for moving food through our bodies, and for digestion and extraction of nutrients from food. Different portions of the GI tract have unique movement patterns, and disorders arise when these movement patterns are altered by GI diseases, systemic diseases, or medications. Frequently seen symptoms of altered GI motility are dysphagia (difficulty swallowing), abdominal pain, bloating, nausea, vomiting, and constipation.
At the Center, we are accustomed to helping patients who also have complex and multiple non-GI related disorders, such as heart or lung conditions or neurological disorders, or those who have undergone solid organ transplantation.
Powerful new drugs and therapies exist for acid-related disorders and problems of GI motility, and we are pleased to offer our patients the best and latest treatments available.
Conditions We Treat
- Gastroesophageal reflux disease (GERD)
- Non-erosive reflux disease
- Non-ulcer dyspepsia
- Peptic ulcer disease (PUD)
- H. pylori infection
- Diffuse esophageal spasm
- Hypercontractile esophagus
- Irritable bowel syndrome
- Intestinal pseudo-obstruction
Columbia’s Center for Motility/Neurogastroenterology performs advanced diagnostic procedures. All of these procedures are done on an outpatient basis.
- High-resolution manometry: in order to visualize movement of the esophagus in those with swallowing problems, we use a trans-nasal probe with highly sensitive pressure monitors.
- Impedance-pH monitoring: using a trans-nasal probe, we are able to assess both the movement of acidic and non-acidic fluid in the esophagus. This enables us to better diagnose those who may have troublesome non-acid reflux.
- Gastric pH measurement: we can measure the pH of gastric juices during a routine upper endoscopy and determine if it is normal, too acidic or not acidic enough.
- Capsule-based 48-hour pH monitoring: for those with refractory or difficult-to-diagnose acid-related symptoms, this wireless technology allows us to precisely determine acidity at the junction of the esophagus and the stomach during normal daily activities.
- High-resolution Anorectal Manometry: in order to visualize movement in the colon and coordination of the pelvic floor in those with chronic constipation, we perform a very simple test using a trans-rectal probe with highly sensitive pressure monitors. This test allows us to understand the cause of your constipation and help direct therapy.
- Wireless Motility Capsule (SmartPill): this multi-vitamin sized disposable capsule is simply swallowed and able to measure pH, pressure and temperature throughout the gastrointestinal tract in order to measure regional transit times throughout the GI tract, pressure patters, and pH in the different portions of the gut. It is most often used for diagnosis in patients with bothersome constipation and gastroparesis (delay in gastric emptying)