Precision-guided diagnosis for digestive rhythm and nerve-control disorders.
Overview
The Motility & Neurogastroenterology unit specialises in disorders where the nerves and muscles of the digestive tract fail to coordinate normally. These conditions cause difficulty swallowing, reflux, bloating, and chronic constipation that persist even when endoscopy results appear normal.
Using high-resolution manometry, pH-impedance monitoring, gastric-emptying studies, and transit testing, our specialists evaluate the movement and nerve signals of the oesophagus, stomach, intestines, and pelvic floor. Treatment focuses on restoring natural digestive motility through medication, diet planning, and targeted biofeedback therapy.
Conditions We Treat
- Achalasia & Esophageal Spasm
- Gastroparesis (Delayed Gastric Emptying)
- Chronic Idiopathic Constipation / Colonic Inertia
- Pelvic Floor Dyssynergia & Functional Outlet Obstruction
- Functional Dyspepsia
- Aerophagia & Reflux Hypersensitivity
- Functional Chest Pain
- Chronic Bloating & Small-Bowel Dysmotility
Achalasia
Overview
Achalasia is a rare esophageal motility disorder in which the lower esophageal sphincter (LES) fails to relax and the muscular contractions of the esophagus become uncoordinated. As a result, food and liquid have difficulty passing into the stomach, leading to progressive swallowing problems and regurgitation.
Symptoms
- Difficulty swallowing: Both solids and liquids (progressive dysphagia)
- Regurgitation: Of undigested food or saliva, especially at night
- Chest pain: Or pressure after meals
- Heartburn-like discomfort: That doesn’t improve with antacids
- Unexplained weight loss
Diagnosis
- High-Resolution Manometry: The gold-standard test that measures pressure changes along the esophagus.
- Barium Swallow: Reveals classic “bird’s beak” narrowing at the lower esophagus.
- Upper GI Endoscopy: Excludes obstruction or malignancy.
Treatment
- Endoscopic Balloon Dilation: Stretches the LES to improve food passage.
- Laparoscopic Heller’s Myotomy: Surgical cutting of the LES muscle fibres.
- Peroral Endoscopic Myotomy (POEM): Minimally invasive endoscopic approach.
- Lifestyle Adjustments: Eating smaller, softer meals.
Gastroparesis (Delayed Gastric Emptying)
Overview
Gastroparesis is a chronic condition in which the stomach muscles do not contract properly, causing delayed emptying of food into the small intestine. It can be triggered by diabetes, viral infections, or post-surgical nerve injury.
Symptoms
- Early satiety: Feeling full after eating small amounts
- Nausea and vomiting: Of undigested food hours after meals
- Bloating: And abdominal discomfort
- Loss of appetite: And unintentional weight loss
- Acid reflux or heartburn
Diagnosis
- Gastric Emptying Scintigraphy: Measures how quickly food leaves the stomach.
- Wireless Motility Capsule: Records pressure and pH through the GI tract.
- Upper Endoscopy: Rules out ulcers or structural obstructions.
Treatment
- Dietary Management: Small, low-fat, low-fibre meals.
- Prokinetic Medications: To stimulate stomach contractions.
- Gastric Electrical Stimulation: For refractory cases.
Chronic Constipation (Colonic Inertia)
Overview
Chronic constipation is a long-standing condition where bowel movements become infrequent, incomplete, or difficult to pass. In colonic inertia, the muscles of the large intestine move stool too slowly.
Symptoms
- Fewer than three bowel movements per week
- Hard, dry, or lumpy stools
- Excessive straining: During defecation
- Sensation of incomplete evacuation
- Abdominal bloating or discomfort
Treatment
- Lifestyle Changes: High-fibre diet and adequate hydration.
- Medications: Osmotic or stimulant laxatives, prokinetic agents.
- Biofeedback Therapy: Pelvic floor retraining.
Pelvic Floor Dysfunction
Overview
Pelvic floor dysfunction refers to the inability to correctly relax and coordinate the muscles of the pelvic floor during bowel movements. This leads to difficulty passing stool and chronic constipation.
Symptoms
- Prolonged straining: During defecation
- Incomplete evacuation: Or need for digital pressure
- Pelvic heaviness or pain: After defecation
- Leakage of stool: Or mucus
Treatment
- Pelvic Floor Biofeedback Therapy: The most effective non-surgical treatment.
- Stool softeners: To ease passage while retraining muscles.
- Physiotherapy: Specialised exercises for muscle coordination.
Functional Dyspepsia
Overview
Functional Dyspepsia is a chronic upper digestive disorder characterised by recurring discomfort or pain in the upper abdomen without any identifiable structural cause.
Symptoms
- Persistent fullness: After meals
- Early satiety: Feeling full after small amounts of food
- Upper abdominal pain: Burning, or bloating
- Nausea: And occasional vomiting
Treatment
- Dietary Modifications: Smaller, frequent meals; avoid spicy, fatty foods.
- Prokinetics: To enhance gastric emptying.
- Acid suppressants: PPIs or H2 blockers.
- Stress Management: Relaxation therapy, yoga.
Bloating & Small Bowel Dysmotility
Overview
Bloating and small bowel dysmotility occur when abnormal intestinal movement or nerve dysfunction causes trapped gas, abdominal distension, and discomfort.
Symptoms
- Persistent bloating: And abdominal fullness
- Visible distension: That worsens through the day
- Excessive gas: Burping, or flatulence
- Early satiety and nausea
Treatment
- Low-FODMAP diet: To reduce fermentable carbohydrates.
- Prokinetic agents: To stimulate intestinal contractions.
- Antibiotics (rifaximin): To treat bacterial overgrowth.
- Probiotics: To restore gut microbiota balance.