Motility & GERD Program
Find relief from chronic heartburn, swallowing difficulty, constipation, and other symptoms caused by the muscle movement of your digestive system.
We’ve all been there—the chest discomfort, belching, sour taste, and indigestion after eating spicy or rich food. But if your gastroesophageal reflux disease (GERD) keeps coming back or you’re having trouble swallowing (dysphagia) or other debilitating symptoms caused by the muscle movement of your GI tract —called motility—it may be time to see a specialist for advanced care.
Our Approach to Motility & GERD Care
Gastrointestinal motility disorders make it difficult for food to move through your body. This can lead to chest pain, difficulty swallowing, a feeling of food being stuck in your throat or chest, nausea, vomiting, cramping, constipation, and diarrhea.
From GERD to gastroparesis to hiatal hernia and any other GI motility issue, our dedicated team of experts use the latest techniques to diagnose and treat any condition affecting your digestive tract, relieving your symptoms and improving your quality of life.
Your Multidisciplinary GERD Care Team
Led by our gastroenterologist fellowship-trained in motility disorders, our team of thoracic foregut and colorectal surgeons, radiologists, and nutritionists uses the latest technologies and therapies to relieve your symptoms. We also partner with specialists in heart and lung health, bariatrics, and other disciplines to ensure you receive the care you need.
Motility & GERD Program Specialists
Your team is led by Zubair Malik, MD, gastroenterologist and motility specialist, and Matthew Puc, MD, thoracic foregut surgeon. Call to request a consultation.
Motility Conditions We Treat
Our team treats the full array of GI motility disorders. These include:
Achalasia: The lower esophageal sphincter (a muscle that separates the bottom of the esophagus and the stomach and acts as a valve that prevents stomach acid from flowing back into the esophagus) does not relax, causing food to get stuck in the area instead of flowing into the stomach. The condition can cause difficulty swallowing, the feeling of food stuck in the throat or chest, regurgitation of undigested food, coughing, choking, vomiting, chest pain, and heartburn.
Barrett’s esophagus: A complication of longstanding GERD, the lining of the esophagus becomes damaged, leading to swallowing difficulties and sometimes chest pain. Untreated Barrett’s esophagus can increase your risk of esophageal cancer.
Bowel problems: These may include fecal incontinence (the inability to control bowel movements, leading to a leakage of stool), chronic constipation (fewer than three bowel movements per week), and frequent diarrhea.
Esophageal cancer: A malignant tumor that originates in the esophagus.
Esophageal diverticulum: A protruding pouch in a weak area of the esophageal lining. Symptoms increase as the pouch grows larger. The most common type is Zenker’s diverticula, a bulging at the back of the throat.
Esophageal spasms: Uncoordinated muscle contractions in the esophagus make it difficult for food and liquid to move into the stomach.
Gastrointestinal reflux disease (GERD): A weak lower esophageal sphincter allows food and/or stomach acid to flow back into and irritate the esophagus. Often referred to as heartburn, GERD also may cause a backwash of sour-tasting food or liquid in the throat and mouth, chronic cough, hoarseness, and sore throat.
Gastroparesis: Weak or uncoordinated contraction of the stomach muscles causes the stomach to empty more slowly than it should, or not at all. Most commonly occurring in people with diabetes, gastroparesis can cause nausea, vomiting, a sensation of fullness after eating a small amount, abdominal pain, and bloating.
Hiatal hernia: The upper part of the stomach bulges through an opening in the diaphragm.
Paraesophageal hernia: Part of the stomach pushes through an opening in the diaphragm into the chest and alongside the esophagus.
Motility Tests and Treatments
Motility Tests
We use the latest technology and advanced tests to confirm the cause and extent of your condition and determine the best treatment.
The most common diagnostic procedure is an upper endoscopy, which is used to visually examine, and, if necessary, take a biopsy of the upper digestive system, including the esophagus, stomach, and upper small bowel.
Additional diagnostic procedures include:
Anorectal manometry: This test evaluates your anal and rectal muscle function and can help determine the cause of chronic constipation or fecal incontinence.
Barium swallow: A liquid barium solution is swallowed while X-rays are taken. The X-rays can detect reflux, hiatal hernia, or obstruction.
EndoFLIP: Performed during an endoscopy to measure the pressure and dimension of the esophagus and other organs to pinpoint the cause of motility problems.
Endoscopic ultrasound (EUS) combines traditional endoscopy with ultrasound imaging to visualize the wall of the GI tract.
Esophageal manometry: A flexible tube is threaded through your nose to the stomach to measure the function of your lower esophageal sphincter and the muscles of the esophagus.
Esophageal pH impedance: Used to diagnose GERD, the doctor inserts a catheter into your nose and extends it to the opening of the stomach. The catheter stays in place for 24 hours and delivers data on your acidity levels to a small computer worn on your belt.
Wireless esophageal pH (Bravo capsule): Used to diagnose GERD, the doctor uses an endoscope to clip a capsule containing a tiny battery, sensor, and transmitter to the bottom of your esophagus. The capsule sends data on your acidity levels to a receiver worn around your waist. After 96 hours, the capsule passes through your digestive system.
Motility Treatments
Medications are often the first line of treatment for GERD and many motility disorders. These may include antacids, histamine blockers, proton pump inhibitors, potassium competitive acid blockers, and prokinetics (drugs that increase smooth muscle contractions along the GI tract).
Other medical and surgical treatments include:
Ablation uses radiofrequency energy or cold to destroy diseased tissue for Barrett’s esophagus or cancer treatments.
Botox injections into muscles of the esophagus or stomach treat muscle spasms, achalasia, or gastroparesis.
Colectomy, a partial or total removal of the colon when needed for severely decreased motility.
Endoscopic anti-reflux procedures transoral incisionless fundoplication (TIF) and Stretta are performed to reduce reflux. TIF tightens the sphincter at the bottom of the esophagus. Stretta burns the sphincter muscle to thicken it. Both procedures are performed completely endoscopically with no incisions on your body.
Endoscopic mucosal resection (EMR), the removal of the top layer of esophageal tissue, treats Barrett’s esophagus or superficial esophageal cancer.
Esophageal dilation uses a special balloon or catheter to widen a narrowed section of the esophagus or stomach.
Esophageal stenting uses a tube to keep open a previously narrowed area of your esophagus so you can swallow more easily.
Hiatal hernia surgery pulls the stomach down into the abdomen and makes the opening in the diaphragm smaller. It also may involve reshaping the muscles of the lower esophagus. The surgery is often performed using a robotic-assisted, minimally invasive approach.
Robotic laparoscopic fundoplication is a minimally invasive procedure where the surgeon wraps the upper part of the stomach around the lower portion of the esophagus to reinforce the lower esophageal sphincter.
Robotic laparoscopic Heller myotomy is a minimally invasive procedure that uses small incisions in the abdomen to open a tight lower esophageal sphincter.
Transoral repair of Zenker’s diverticulum is an incision-less approach to removing a pouch or pocket (diverticulum) in the lining of the upper part of the esophagus.
Other therapies may include dietary changes, acupuncture, pelvic floor muscle therapy, and relaxation training.
The Virtua Difference for Motility and GERD Care
Multidisciplinary Approach
Highly trained interventional gastroenterologists and surgeons treat your entire digestive system—from top to bottom.
Multidisciplinary Approach
Highly trained interventional gastroenterologists and surgeons treat your entire digestive system—from top to bottom.
The Most Comprehensive Motility Program in South Jersey
Our specialists use the most advanced technologies and approaches to resolve your condition and improve your quality of life.
The Most Comprehensive Motility Program in South Jersey
Our specialists use the most advanced technologies and approaches to resolve your condition and improve your quality of life.
Minimally Invasive Procedures
Many procedures can now be performed endoscopically, requiring no incisions, or through a robotic-assisted, minimally invasive approach—resulting in less post-operative pain and a faster recovery.
Minimally Invasive Procedures
Many procedures can now be performed endoscopically, requiring no incisions, or through a robotic-assisted, minimally invasive approach—resulting in less post-operative pain and a faster recovery.
It's All About You
Personalized treatment plans are developed in coordination with your primary gastroenterologist and care team.
It's All About You
Personalized treatment plans are developed in coordination with your primary gastroenterologist and care team.
Request an Appointment
If you are not experiencing relief of your symptoms, speak with your gastroenterologist for referral to a Virtua Motility & GERD program specialist.