Understanding Motilty Study Results- UES

[overit4now]

I just got back results from my Motility Study. I have been having a dysphagia, chest pains, and issues. The doctor seemed to think that everything looked pretty good. My last few swallows showed some problems and signs of spasm but since the others looked good the doctor seemed to dismiss these. As I read through the information, I see the upper esophageal sphincter had out of range readings which were never discussed. Can anyone help decipher what these mean? I was referred to an ENT.

Upper Esophageal Sphincter
Mean basal pressure      31.3mmHg  range (34-104)
Mean residual pressure   -1.9 (<12)
Relaxation time-to-nadir  81ms (74-365)
Relaxation duration        1158 (480-1020)
Recovery time               1076 (259-760)

[patient915]

Good, your dietary changes will hopefully help you figure out what is wrong.  Nortriptyline is a good med for treating unexplained pain (I've been on it before).

[overit4now]

The PPI's actually made it worse. I had some mild reflux and only occasionally bad when I start Prilosec it got worse. The doc said to take it 2x a day and that did not help. I swtiched to Dexilant which I think may have worked better, but too expensive. Now I am off all PPI's for the past 3 days and reflux is pretty mild. In January I switched to a very low acid diet this might be why I thought the Dexilant worked better. For the past 3 days I have started a very strict diet to check for food allergies even though the skin tests all came out negative. At the moment I am gluten free, corn free, sugar free, alcohol free, no red meat, no "mold" foods, no "latex" foods, and RD has me on a blood type diet for type A (not sure about that, but trying for now). It's tough. Just start Nortriptyline (sp?) last night. Went GP yesterday EKG normal. He said results just showed that things were moving kind of slow and also thought I should see the ENT.

[patient915]

Have any medications for GERD helped your problems?  Have you tried any dietary changes?

[overit4now]

Thank you! I have had 2 endoscopies. The first by my GI found a stricture and did a dialation which did not seem to help. I was referred to a motility specialist. I had an endoscopy which was pretty norm only a few slight mucosal changes. All biopsies can out negative. Had 24 pH impedence study which show reflux but was told not enough to be "clinical", had barium swallow show slight narrrowing fusiform shape, had CT everything looks fine but showed possible free flowing reflux. Esophageal Manometry results looked good as well. There were a few numbers out of range here or there. My last 2 swallows out of 12 showed some irregulaties but doctor seems to want to dismiss these since all of the other look fine. I was having pain issues in my mid-sternum area of my esophagus but this is not so bad now. I seem to be having more problems in my throat area with things feeling stuck or very slowly moving down and occasional choking on small particles. The doctor thinks I may just have a hypersensitive esophagus and suggesed I try Nortriptyline and is referring me to an ENT. I have been having bad shooting chest pain on the right side which they thought might be esophageal spasms. So much time has passed through this process which began in October and my symptoms keep changing. I know no news is good news, but really just want some answers.

[patient915]

Welcome to the gastroenterology community!  I think you should really talk to your doctor again about these results.  It seems like every place does their testing a little bit differently so I don't quite know what to tell you in regards to the actual numbers in your results.  Have you had an endoscopy done?