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YOU ARE HERE

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 * Gastroenterology, Hepatology and Nutrition
 * Motility Disorders Program


YOU ARE HERE

 * Home
 * Gastroenterology, Hepatology and Nutrition
 * Motility Disorders Program


MOTILITY DISORDERS PROGRAM

The Neurogastroenterology and Motility team at Children’s Hospital Los Angeles
is dedicated to providing high quality and comprehensive care to children with
gastrointestinal sensory and motility disorders. In a healthy child the nerves
and muscles of the digestive tract work together to move food through the body
from the mouth to the anus. At any point along the digestive tract problems with
tissues, nerves, or muscles can result in difficulty swallowing, abdominal pain,
constipation, bloating, nausea and vomiting, and impaired growth. At Children’s
Hospital Los Angeles we utilize cutting edge techniques in the diagnosis and
management of various conditions. Our team of specialists is trained to
understand and treat motility disorders that can be difficult to diagnose or
manage. 


COMPREHENSIVE CARE

At Children’s Hospital Los Angeles we know that children suffering from
gastrointestinal motility problems have a variety of chronic symptoms that can
cause significant physical and emotional stress for both children and their
parents. Our multidisciplinary team of doctors, nurses, physical therapists,
social workers, and dieticians is committed to providing individualized,
customized diagnostic and treatment plans. We work closely with our patients and
their families, along with their primary gastrointestinal physician, to address
all aspects of the child’s well-being. Our personalized treatment plans may
include medications, nutrition, behavior modifications, surgery, or endoscopic
therapy. Our specialized and dedicated nursing team is enurse easy communication
with families and coordination of multi-specialty care plans.

Advanced GI motility testing: Gastrointestinal motility disorders can be
difficult to diagnose and require advanced techniques for testing. These
procedures help our team better understand your child’s symptoms and guide a
treatment plan.  The Neurogastroenterology and Motility Program at Children’s
Hospital Los Angeles is one of only a handful of programs in the country that
offer specialized pediatric GI motility testing.

Anorectal Manometry: Anorectal Manometry is used to evaluate patients with
constipation or fecal incontinence. This test measures the pressures of the anal
sphincter muscles, the sensation in the rectum, and the nerve reflexes that are
needed for normal bowel movements. A thin and flexible pressure-sensing tube is
placed into the anus and connected to a computer that takes the recordings.
Anorectal manometry testing usually occurs as an outpatient and no sedation
required. The testing appointment will last approximately 1 hour. An enema or
rectal suppository is typically required prior to testing because an empty
rectum is needed for this testing.

 Esophageal Manometry:  Esophageal Manometry is used to evaluate patients with
swallowing problems. This test measures the strength and function of the muscles
in your esophagus (the “food pipe”) that work to push food and liquids from the
mouth down to the stomach. A thin and flexible pressure-sensing tube is placed
down the nose and throat into the esophagus and connected to a computer that
takes measurements during swallowing. This test usually occurs as an outpatient
and no sedation is required. Topical lidocaine is inserted into the nostrils
prior to the study to make insertion of the catheter from the nose into the
stomach less uncomfortable. The study lasts about 60-90 minutes. The patient is
not allowed to eat 2 hours prior to the study.

Antroduodenal Manometry: Antroduodenal or small bowel manometry is used to
evaluate patients with nausea or vomiting. The test measures the strength and
coordination of the muscle contractions of the stomach and small intestine
during three phases: fasting, after a meal, and medication administration. This
testing is typically done in the hospital. A thin, flexible pressure-sensing
catheter is placed while under anesthesia. This may placed through the nose,
past the stomach into the small intestine by the Interventional Radiology
Department, or through an existing g-tube by a gastroenterologist. Once the
patient recovers from anesthesia the catheter will be connected to a computer
that measures muscle contractions for about 6-8 hours. The child goes home after
the study.

Colonic Manometry:  Colonic Manometry is used to evaluate patients with severe
constipation. The test measures the strength and coordination of contractions of
the colon (or large intestine) during three phases: fasting, after a meal, and
medication administration. This testing is done in the hospital. The child is
typically admitted 1-2 days prior to the procedure in order to complete a bowel
clean out, as an empty colon is needed for the study. The pressure-sensing
catheter is placed during a colonoscopy in the operating room while the child is
under anesthesia. Once the patient recovers from anesthesia the catheter is
connecter to a computer that measures muscle contractions for approximately 6-8
hours. The child goes home after the study.

Depending on the needs of the child, several studies may be performed while the
child is in the hospital.


CLINICAL TRIALS AND RESEARCH

 * Anorectal Manometry Versus Rectal Biopsy in Diagnosing Hirchprung’s Disease
 * The effect of abdominal massage on colonic motility patterns


WHAT TO EXPECT DURING YOUR FIRST VISIT

During the visit you will meet different members of our motility team including
physicians, nurses, and physicians in training.  Your doctor will review
information about the child’s problem, past testing and treatments, and the
parent’s concerns and do a complete physical examination. Together a plan will
be made and recommendations treatment and necessary testing will be discussed.
To ensure a thorough evaluation please provide results of any prior testing
before or at the time of your clinic appointment. Unless specifically discussed
prior to your visit motility testing is not usually done at the time of the
first visit. 


COMMONLY TREATED DISORDERS

Our team cares for motility disorders associated with:

 * Achalasia
 * Chronic severe constipation
 * Encopresis
 * Feeding difficulties
 * Gastroparesis
 * Hirchsprung’s disease
 * Irritable Bowel Syndrome
 * Megacolon
 * Non-retentive fecal incontinence
 * Pseudo-obstruction
 * Rumination disorder
 * Swallowing problems
 * Unspecified functional motility disorders
 * Anorectal malformations
 * Spinal cord injuries or abnormalities with secondary stooling problems
 * Pelvic Floor Dysfunction





CONTACT US

Children's Hospital Los Angeles
Motility Disorders Program
4650 Sunset Blvd.
MS #78
Los Angeles, CA 90027
United States

Phone: 323-361-2181

Fax: 323-361-3718

Meet Our Doctors


RESOURCES

American Neurogastroenterology and Motility Society

International Foundation for Functional Gastrointestinal Disorders


SERVICES

Gastrointestinal Motility Testing

Pelvic Floor Physical Therapy


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