Tertiary Contractions and Abnormal motility On Esophogram

Tertiary contractions of esophagus and dysmotility are ways of saying that the tube that runs from the throat to the stomach called the esophagus is not working like it should.  The esophagus is not pushing food down in a coordinated efficient manner.

Symptoms of esophageal dysmotility and tertiary contractions

This can cause trouble with swallowing, heart burn, food getting stuck and chest pain.

What do tertiary contractions of the esophagus mean?

Tertiary contractions are dysfunctional contractions of the esophagus which do not push food down.  These can be seen with motility disorders of the esophagus.  These do not always cause symptoms.

What causes esophageal dysmotility?

Esophageal dysmotility can be caused by problems of the esophagus such as inflammation or cancer, a nerve problem such as a stroke, or abnormal muscles of the esophagus.  While there are many tests to investigate this problem, one of the quickest and easiest is a barium swallow.

What type of testing is done for esophageal motility problems?

Esophagrams will often be done to evaluate problems with esophageal motility.  This will involve the Radiologist observing the function of the esophagus under X-ray while you swallow barium contrast.

The radiologist will see how the esophagus works and pushes food down into the stomach after you swallow.  The radiologist will also diagnose any structural problems like narrowings and masses.  The radiologist may be able to make a specific diagnosis in some cases and grade the severity of your problem.

What are esophageal spasms?

One variant that can be seen on barium esophagrams is esophageal spasm.  These are abnormal contractions of the esophagus which make it harder for food to reach your stomach.  This can cause chest pain or trouble swallowing.

What are some conditions that can cause motility problems with the esophagus?

Gastric reflux or heart burn can also be associated with abnormal esophageal muscle function or dysmotility.

A disease of the esophagus called achalasia is associated with tertiary contractions and dysmotility.  In this disorder, the end of the esophagus fails to relax and let food through.  Eventually, the function of the muscle in the esophagus is lost.  The esophagus looks big and dilated with retained food.

Treatment for esophageal dysmotility and tertiary contractions

Patients with dysmotility and tertiary contractions of the esophagus will often be referred to a specialist called a gastroenterologist.  He may do additional tests such as endoscopy and pressure measurements to further assess.  Treatment is varied but may include medications, endoscopy and surgery in some cases.


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