Why Choose the Program for Precision Diagnosis and Therapy for Pediatric Motility Disorders

Cutting-edge treatments, life-changing care

The goal of our program is to provide precision diagnosis, cutting-edge treatments and advanced therapies to children with intractable motility disorders, ultimately improving their overall quality of life.

Our program offers:

  • An experienced, multidisciplinary team of motility specialists, GI nurses, psychologists, dieticians, surgeons, otolaryngologists, pathologists, geneticists, gastroenterologists, mitochondrial specialists, an interventional radiologist, a biomedical engineer and advanced practice providers who are experts in the diagnosis and management of complex motility concerns
  • A coordinated approach to each child’s evaluation and treatment
  • The newest and most innovative diagnostic and therapeutic modalities available today – including many that have been clinically trialed and proven effective here at CHOP
  • Regular communication with families, referring physicians and specialists to create comprehensive care plans that meet each child’s individual needs
  • Ongoing research to learn more about motility disorders, explore new testing and treatment options, and enhance outcomes for all children with motility disorders

Motility disorders were virtually unheard of 30 years ago, and although still rare, they have grown in frequency and severity in recent years. One of the strengths of our motility program is our ability to offer a full range of motility testing, including:

  • Manometric studies, to measure how quickly food is processed in the upper and lower GI tract (esophageal, antroduodenal, colonic and anorectal)
  • EndoFlip, to provide details about a child’s organ dimensions and pressure to help plan treatments and determine the effectiveness of treatment
  • EsoFlip, to dilate the esophagus and examine it without any radiation, as would be needed with standard imaging tests. In some case, therapeutic dilation can act as a treatment to relieve symptoms.
  • Percutaneous electrical nerve field stimulation (PENFS), which uses electrical pulses to lessen abdominal pain
  • pH-impedance monitoring
  • Hydrogen breath testing
  • Botox injections to improve sphincter function
  • Medical neuromodulation to manage symptoms
  • Single- and double-balloon enterostomy, which can be used to diagnose – and sometimes treat – motility concerns by widening the GI tract
  • Smart pill to check transit time through the GI system
  • Electrogastrography, to assess gastric myoelectrical function
  • Pelvic floor dynamic evaluation with balloon expulsion test and biofeedback training

Newer technologies we are actively studying for use with motility patients at CHOP include:

  • Body surface gastric mapping (BSGM), which offers a more complete understanding of gastric functioning in the individual patient
  • Heart-rate variability biofeedback, which aims to reduce stress and improve gastric function
  • Gastric electrical stimulation (GES), which uses electrical stimulation to improve gastric emptying
  • Translumbosacral anorectal magnetic stimulation (TAMS), which delivers focused magnetic energy through an insulated coil to the lumbo-sacral nerves that regulate anorectal function
  • Sacral nerve stimulation, which can improve fecal incontinence
  • Cine-MRI imaging of the bowel, which offers clues about bowel function

Ongoing motility research

Research is an integral part of our Pediatric Motility Disorders Program. As we work to develop a broad, evidence-based approach to the management of motility disorders, we must first ensure we have accurate and meaningful data.

Our physicians and researchers are actively working on:

  • Expanding our knowledge of gastroparesis and disordered gut/brain interactions using BSGM, and offering EsoFlip and heart rate variability biofeedback
  • Studying the effectiveness of GES and PENFS, in treating patients with intractable gastroparesis and functional dyspepsia
  • Collaborating with CHOP’s Center for Pediatric Airway Disorders, to offer new dimensions in management of esophageal diseases, swallowing disorders and gastroesophageal reflux disease
  • Better managing patients with achalasia and eosinophilic esophagitis (EoE) with advanced dilation techniques using EndoFlip and EsoFlip
  • Expanding colorectal research and care by offering: TAMS, Cine-MRI imaging, Troponin T (TnT), and sacral nerve stimulation to patients with fecal incontinence

By addressing symptoms that have a debilitating effect on our patients’ lives, we can help more children get back to their typical activities of daily living.