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.
This can cause trouble with swallowing, heart burn, food getting stuck and chest pain. In some patients as they age, tertiary contractions occur which are contractions of the esophagus which do not push food down. These can be without symptoms.
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 many tests to investigate this problem, one of the quickest and easiest is a barium swallow.
This will involve swallowing barium and X-ray pictures being taken. This will allow the radiologist to observe directly how your esophagus works and pushes food down into the stomach after you swallow. The radiologist may be able to make a specific diagnosis in some cases and grade the severity of your problem.
One variant that can be seen on barium esophograms is esophageal spasm. Multiple tertiary contractions can be seen and can be associated with chest pain or trouble swallowing. Gastric reflux 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 before it joins the stomach 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.
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.