Gastrointestinal Motility Test - Indications, Types, and Techniques

Introduction:

GI (gastrointestinal) motility test is performed to check if the food consumed is digested and moved around the digestive system normally. A motility disorder is a condition that affects the way the food travels between the esophagus, stomach, and intestines. Motility disorders may affect any part of the gastrointestinal tract. Many other diseases also cause motility disorders. This test helps find the cause and treatment of the disease.

Why Is the GI Motility Test Performed?

• The mouth, esophagus, stomach, and intestine together form the gastrointestinal tract. The food we consume reaches the stomach when we swallow. The esophagus forms the route through which the food reaches the stomach. The muscles in the esophagus shrink and push down the food into the stomach. The stomach holds the food temporarily, and the food is broken down when digestive acids and enzymes act on them.

• The stomach then transfers the food to the small intestine, where the nutrition is absorbed from the food and is further digested by bile and enzymes released by the pancreas. The small intestine has three parts duodenum, jejunum, and ileum. The digested food then reaches the large intestine, which processes waste products to the rectum (the third part of the large intestine, which moves the waste from the food or stools to the anus). The large intestines have four parts: the cecum, colon, rectum, and anus.

• There will be motility disorder if these muscular organs do not carry out any function correctly. Thus, this test is performed to find out the causes of a motility disorder.

What Are the Types of GI Motility Tests?

• Anorectal Manometry: This test detects the rectum's muscular activity and reflex sensation. A catheter (a small, elastic, and compressible tube) is inserted into the rectum. The catheter has a sensor on one end to identify the pressure. The other end has a balloon and is used to inflate to check the rectum's muscular activity and nerve reflex with different air pressures. This test is performed on patients to find constipation and incontinence (loss of control).

• Antroduodenal Manometry: A thin, adjustable tube with a pressure sensor is inserted into the stomach and the small intestine through the nose. This test detects the muscle strength of the stomach and the duodenum (the first part of the small intestine). This test helps find dyspepsia (pain or discomfort in the upper part of the stomach), unexplained vomiting, and gastroparesis (a condition where the stomach does not empty the waste properly).

• Bravo pH Test: This test is used to find the quantity of acid present in the esophagus. A flimsy, bendable tube with a capsule containing an acid sensor is inserted into the mouth to check the acid backflow into the esophagus.

• Hydrogen Breath Testing: This test uses the patient's breath to measure the volume of the hydrogen gas present in the breath. The patient is asked to consume a sugar solution and breathe air every 15-minutes for two hours. If the bacterias present in the small intestine are large in quantity, they will release hydrogen. This is absorbed into the blood, which reaches the lung and is breathed out. This test also helps find lactose or fructose intolerance.

• Colonic Manometry: This method is performed by inserting a colonoscope and a guide wire. The motility wire is inserted with the guided wire as assistance. The motility wire is a straw-like tube with tiny holes at regular intervals to measure the pressure of the colon. The pressure in different areas of the colon while doing different actions like taking medicines by mouth, drinking, injecting medications, and allowing them to eat is measured.

• Esophageal Manometry: This test is used to determine weak and irregular esophageal muscle function. A thin, bendable tube is inserted into the throat through the nose. The patient is asked to swallow. The muscles at the top and bottom of the esophagus (sphincter muscles) are checked for changes in the pattern and the pressure when the muscles contract. It helps find out diseases like achalasia and diffuse esophageal spasm. Achalasia is a rare condition where the lower esophageal sphincter muscle fails to relax, and the food does not reach the stomach. This causes difficulty in swallowing and regurgitation, and the food comes up to the throat. Diffuse esophageal spasm is a condition where the esophageal muscle does not contract in a regular pattern and causes difficulty in swallowing.

• Esophageal Impedance: Esophageal impedance uses a slender, bendable tube called a catheter with a sensor that records the stomach acid in the throat. The catheter is inserted into the nose to reach the food pipe. The recording device measures the acid that flows back from the stomach into the food pipe. This test is performed to find gastroesophageal reflux disease (GERD), postsurgical and presurgical heartburn, non-cardiac chest pain, etc.

• Sitzmark Duty: In this study, the patient is given a capsule with minute markers that will be visible while taking an X-ray. The patient takes the tablet, and the X-ray is performed five days after ingesting the pill. The abdominal X-rays will reveal the markers present in the intestine or whether it has been excreted from the colon. This test is performed on patients having severe constipation (no regular bowel movements for more than two times a week) to know the status of bowel movements.

• Endoscopy: This procedure finds diseases like gastroesophageal reflux disease, dyspepsia, esophagitis (inflammation or injury to the esophageal tissues), and ulcers (inflammation in the lining of the gastrointestinal tract). A slender, flexible tube with a camera is inserted into the throat to view the abnormalities in the gastrointestinal tract.

• X-Rays or Other Imaging Tests: X-rays use radio waves to take pictures of structures or bones. Other imaging tests like computerized tomography (CT) scan and magnetic resonance imaging (MRI) give a detailed view of the organs to detect any defects or blockages. Computerized tomography (CT) scan uses X-ray waves to take pictures of the targeted organ with the help of computer technology. Magnetic resonance imaging (MRI) combines high-frequency sound waves and magnetic fields to take images of the organ or structure.

How to Prepare for a GI Motility Test?

• Avoid eating food or drinking liquids after midnight on the previous night of the test.

• The physician may recommend stopping a few medications. The list of drugs includes Reglan, Zelnorm, Erythromycin, and Motilium. These medications induce muscle contraction to empty the bowel contents. Antispasmodic drugs (used to relieve muscle spasms) like Benadryl, Donnatal, and Levsin are also advised to stop. These medications need to be stopped two days before the procedure.

• A loose, buttoned shirt or dress will be a preferred attire on the test day.

What Are the Importance of GI Motility Disorders?

• It helps in finding the disease accurately.

• It helps with planning the treatment.

• It is used to see the prognosis status of the disease.

What Are the Symptoms of GI Motility Disorders?

• Constipation.

• Diarrhea.

• Bloating feeling in the abdomen.

• Pain in the stomach.

• Nausea.

• Difficulty in eating and swallowing.

• Weight loss.

• Heartburn.

• Regurgitation (unforced spitting of food due to vigorous contraction of muscles in the abdomen).

Conclusion:

The GI motility test is performed to rule out the underlying disease in the gastrointestinal tract. The test is performed both on kids and adults. The physician recommends these tests when the symptoms do not resolve with baseline treatments or due to chronic symptoms (present for a long time). The tests are advised depending on the type and location of the pain or discomfort. Each test has a different method, and accordingly, the diseases are found. Some tests need hospitalization, and some tests are performed in one day, and the patient is sent home the same day. GI (gastrointestinal) motility test helps find the disease and helps find how far the disease has been cured. The disorders are swiftly found with these GI motility tests, and the treatments for the gastrointestinal diseases are planned for a speedy recovery of the patient.