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Abnormal Propulsion of Food

(Esophageal Motility Disorders)

by Michael C. DiMarino, MD

The movement of food from mouth to stomach requires normal and coordinated action of the mouth and throat, propulsive waves of the esophagus, and relaxation of the sphincters. A problem with any of these functions can cause difficulty swallowing (dysphagia—see Difficulty Swallowing), heartburn, chest pain, regurgitation (the spitting up of food from the esophagus or stomach without nausea or forceful contractions of abdominal muscles—see Regurgitation and Rumination), vomiting, or aspiration of food (sucking food into the airways when inhaling).

Disorders of the throat can cause problems with the movement of food (see Propulsion Disorders of the Throat).

The main causes of abnormal propulsion of food are movement (motility) disorders of the esophagus. The most common disorders include achalasia (see Achalasia) and esophageal spasm (see Esophageal Spasm). Sometimes, disorders that affect the whole body also affect movement of the esophagus. Examples include systemic sclerosis (see Systemic Sclerosis) and Chagas disease (see Table: Chagas Disease).

Doctors use various methods to diagnose movement disorders of the esophagus. Methods include endoscopy, barium swallow x-rays, manometry, and acid-related or reflux-related tests (see Diagnosis of Digestive Disorders).

Treatment depends on the cause.