Motility/Neurogastroenterology

The Nation’s Largest Motility Clinic

When you eat, dozens of muscles and nerves activate to make sure your body can properly break down and move food from your esophagus down to your stomach, small intestine, and colon. If you have a problem with any of these muscles or nerves, you may need the help of a neurogastroenterologist, or motility specialist — a specialty that is only available regionally at Augusta University Digestive Health Center.

This unique field treats muscle or nerve problems in the esophagus, stomach, small intestine, and colon that stop or slow digestion. In fact, the Augusta University Digestive Health Center offers the largest motility clinic in the U.S. — and one of only 10 in the nation designated as a Center of Excellence by the American Neurogastroenterology and Motility Society.

Our center provides comprehensive care for a broad category of motility disorders, including: 

Esophagus

  • Dysphagia, difficulty swallowing
  • Achalasia, when esophageal muscles don’t work properly, causing food to accumulate in the esophagus
  • Esophageal chest pain, muscle spasms or hypersensitivity in the esophagus
  • Gastroesophageal reflux disease (GERD), chronic heartburn

Stomach and Small Intestine

  • Gastroparesis, stomach paralysis
  • Functional dyspepsia, stomach pain not caused by an ulcer
  • Small bowel dysmotility and pseudo-obstruction syndrome, muscle or nerve abnormalities that slow or stop digestion, trapping food
  • Lactose/fructose/fructan intolerance, an “allergy” to these common food products, causing bloating or gas and preventing digestion
  • Small intestine bacterial overgrowth or fungal overgrowth, a common side effect of stomach or intestinal disorders
  • Pseudoobstruction syndromes

Colon or Large Intestine

  • Constipation or dyssynergic defecation
  • Fecal incontinence, leakage of stool
  • Irritable bowel syndrome, a chronic condition causing cramping, diarrhea, constipation, bloating, and gas
  • Levator ani syndrome, rectal pain caused by muscle spasms

Treatments

Many of our specialized treatments are available nowhere else in the region and are supported by specially trained staff who work closely with you to answer any questions you might have. Because of the sensitive nature of many of these procedures, we also take extra steps to safeguard your privacy.

Esophagus

  • Esophageal manometry or high-resolution esophageal and pressure topography (HREPT). A tube is passed through your nose and into your esophagus to learn how the muscles of your throat and esophagus work as you eat and drink.
  • 3-D esophageal manometry. This test provides a three-dimensional view of the esophagus and how lower esophageal and upper esophageal sphincter muscles work as you eat and drink.
  • 24-hour ambulatory pH test. During this one-day test, a pH probe (a soft, plastic tube) is placed in the esophagus through the nose to measure the amount of acid that is refluxing or backing up into the esophagus. Esophageal manometry may also be used to help place the tube correctly.
  • 24-hour oropharyngeal pH test. During this test, a catheter with a portable recorder is inserted through your nose and placed in the back of your throat. During the course of your daily activity, it records the amount of acid (pH) that getting into the back of your throat.
  • 48-hour and 96-hour ambulatory pH/Bravo test. This two to four-day test involves attaching a Bravo pH capsule, a small detector to the lining of your esophagus, usually with upper endoscopy and record the amount of acid reflux.
  • Esophageal balloon distension test: A probe with balloon is placed in the esophagus to test esophageal sensation in patients with non-cardiac chest pain.
  • Achalasia balloon dilation. During this nonsurgical procedure, a physician inserts a specially designed balloon through the lower esophageal sphincter and inflates it under X-ray guidance. The balloon disrupts the esophageal muscle and widens the opening for food to enter the stomach.
  • EndoFLIP. The Endolumenal Functional Lumen Imaging Probe is a new diagnostic test that measures esophageal function.
  • Botulinum toxin injections. These injections relax muscles and treat achalasia, or an inability of the esophagus to move food to the stomach.

Stomach and Small Intestine

  • Botulinum toxin injections. These injections relax muscles and treat paralyzed stomach that is not improving.
  • Gastric barostat study. A tube and balloon are passed into your stomach to measure tone and activity of the stomach muscles and how you sense food in the stomach.
  • Enterra therapy. Patients with chronic nausea and vomiting associated with gastroparesis can benefit from a gastric pacemaker implanted in the stomach that provides electric stimulation to stomach muscles.
  • Gastric pacemaker interrogation. This procedure evaluates if your gastric pacemaker is functioning properly, using a monitoring device placed over your abdomen.
  • 24-hour gastric-duodenal manometry study. This 24-hour study uses a probe inserted through your nose or mouth into the small intestine (usually with the help of an upper endoscope) to evaluate the muscle activity of your stomach and small intestine during fasting, after a meal, and during sleep.
  • Hydrogen breath test. Our lactose/fructose/fructan intolerance clinic and small intestine bacterial overgrowth clinic use breath tests to confirm problems digesting certain sugars or carbohydrates and to detect small intestinal bacterial overgrowth.

Colon or Large Intestine

  • 24-hour ambulatory colonic manometry study. This 24-hour test involves a colonoscopy and placement of a special manometer probe and balloon into your colon. The study provides information on the pattern of contractions during fasting, eating, and sleeping, as well as colonic sensation and tone.
  • SmartPill or wireless motility capsule study. About the size of a big multivitamin, the SmartPill travels through your digestive tract, mimicking the speed that food would travel. It measures the time it takes for your stomach, small intestine, and colon to digest food, as well as muscle contractions and pH.
  • Anorectal manometry. Our specially trained nursing staff place a catheter about the size of a pencil six inches inside the rectum to assess the strength of the anal muscles, rectal sensation, the ability to have a bowel movement, the ability to squeeze and hold a volume of fluid.
  • Translumbar and transsacral motor evoked potential (nerve conduction) test. This test pioneered at Augusta University Health uses a magnetic coil that is placed on your lower back, to test the nerves that supply your anal and bowel muscles in a non-invasive manner.
  • Rectal barostat study. A thin probe is placed in the rectum, and a balloon is inflated and deflated to assess rectal sensation and muscle response.
  • Biofeedback therapy. Adults suffering from chronic constipation, stool leakage, or poor rectal sensation or children with stool leakage or retention may benefit from biofeedback to help retrain rectal muscles. Therapy typically involves six sessions over 12 weeks.
  • Colonic transit study. A capsule is ingested to measure the time it takes for stool to move through your colon. You will also need an X-ray at five days.
  • Repetitive translumbar and transsacral magnetic stimulation therapy. Using a magnetic coil placed on your lower back, our specially trained staff provides electrical stimulation to the nerves that supply your anal and bowel muscles. Treatments are typically repeated every one to two weeks, and up to six sessions may be required. This treatment was pioneered at Augusta University Health.
  • Fecal microbiota transplantation. Patients who have a serious infection of the colon caused by Clostridium difficile (C. diff) bacteria that does not respond to antibiotics may benefit from transplantation of stool from a healthy donor. Up to 90 percent of patients with C. diff infection improve with this treatment.
  • Botulinum toxin injections. These injections relax muscles and treat anal fissures that are not healing.
  • 3-D high-definition manometry. This test provides a three-dimensional display of anorectal pressure.
  • 3-D anorectal and pelvic ultrasound. This exam visualizes the anal sphincter, rectum and pelvic floor without X-ray.

Meet Your Motility Team

Dr. Satish Rao, neurogastroenterology and motility

Nicole Shaffer, advanced registered nurse practitioner, neurogastroenterology and motility

Arie Mack, registered nurse and Coordinator, Motility Lab

Anne Dewitt, registered nurse and Biofeedback Therapist

Andy Yurechko, RD, clinical nutrition, dietary services and food intolerances

Schedule Your Appointment Now

Schedule an online appointment or call 706-446-GUTS (4887) to speak to a member of our digestive health team.

Learn More

Irritable Bowel Syndrome

Should you be taking a probiotic? (Elle magazine July 2014, featuring Dr. Satish Rao)