Motility Disorders

Relief from Chronic Constipation, Painful Abdominal Contractions

Chronic constipation, abdominal swelling, and difficulty with swallowing may signal that your child has an intestinal motility disorder. The abnormal movement of food and drink through the GI tract can be difficult to diagnose. Duke’s pediatric GI team is highly skilled in identifying the cause of these conditions and helping children find relief. Our goal is to manage or eliminate symptoms and boost nutrition so your child can return to school and his or her favorite activities as soon as possible.

What Is a Motility Disorder?

Motility disorders occur in the upper and lower sections of the digestive tract. They include:

  • Achalasia, which occurs when the esophagus cannot move correctly, leading to food backing up into the esophagus. This causes swallowing difficulties and vomiting.
  • Gastroparesis, a delay of food moving from the stomach into the intestines. This can cause severe nausea, vomiting, abdominal pain, and weight loss.
  • Pseudo-obstruction, which can be caused by slow movement of the small intestines, leading to abdominal distention and difficulties with eating.
  • Chronic constipation. When a child's inability to have regular bowel movements is severe, blocks can form and can cause them to leak stool.

Our team of doctors is actively collecting data, especially about lower digestive-tract conditions such as chronic constipation, to share with other experts and improve available treatments.

How We Diagnose Motility Disorders

Our pediatric motility specialists use a variety of tests to diagnose the cause of your child’s pain and discomfort. Our motility team will talk with you and your child to take a very careful medical history. Your child’s doctor will determine which tests are needed, based on whether the problem is an upper or lower gastrointestinal issue. Lab tests, such as blood work, and X-rays are often prescribed. Other outpatient tests may include:

  • Manometry: Studies how muscles contract and whether the squeezing action is strong or weak. This helps us determine how the gastrointestinal tract moves food and stool. Manometry can be used to test movement in the esophagus, small intestines, colon, and anus. Studies that look at the small intestine and colon may require an overnight hospital stay.
  • Upper GI X-ray: Pictures of the esophagus and stomach are taken as your child swallows food or drink with a contrast substance added to make it stand out visually.
  • Gastric Emptying Study: Monitors how food travels out of the stomach. A child swallows food or drink with an added contrast material. Doctors record and watch the material as it travels out of the stomach.
  • Upper endoscopy: The doctor uses a thin, lighted tube with a camera to look inside the esophagus, stomach, and small intestine for damaged tissue. The tube is inserted through the mouth and down the throat. This can also be used to place other tubes needed for esophageal and small intestine manometry studies.
  • Colonoscopy: The doctor uses thin, lighted tubes to check the linings of the intestines and colon. This can also be used to place other tubes needed for colonic manometry studies.

Our doctors use the test results to create the best treatment plan for your child.


A variety of treatments are available to reduce symptoms and correct digestive and bowel movement problems. Our doctors, nurses, physical therapists, and dietitians will work with your child and you to build a care plan that best meets your family’s needs. We are committed to helping your child feel better and in control of their body. The effectiveness of treatments depends on your child’s specific condition. We also work with your local pediatric gastroenterologist to continue your care after you are away from Duke.

Family and Support Services

When you bring your child to Duke Children’s, you may feel overwhelmed and have a lot of questions. Our team is here to help. Our doctors and nurses connect your child and you to many supportive services designed to make the experience more comfortable and positive.

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