SCHOOL OF MEDICINE

Department of Medicine

Gastroenterology Hepatology

GI Motility and Neurogastroenterology Unit

The GI Motility Program at Indiana University Health is a regional referral center of excellence for GI Motility Disorders. Currently, we have 6 adult and 2 pediatric gastroenterologists at IU Health with special interest in Motility. The Motility Clinic will utilize diagnostic testing and multidisciplinary evaluation from other expertise within the Indiana University School of Medicine, including GI, radiology, nuclear medicine, neurology, surgery (laparoscopic and colorectal), urogynecology, GI neuromuscular pathology, medical genetics, biofeedback therapy, and speech therapy.
Team
Research Staff
GI Neuromuscular Pathologist
Colorectal Surgeons
Medical and Molecular Genetics
Urogynecologists
Motility Laboratories
The Indiana University GI Motility Laboratory at IU Hospital is the only comprehensive state-of-the-art diagnostic center in Indiana for patients with motility and functional disorders, such as gastroesophageal reflux, chronic cough, non-cardiac chest pain, dysphagia, gastroparesis, nausea, vomiting, bloating, constipation and fecal incontinence. These common problems are seen by general practitioners, gastroenterologists, pulmonologists, ENT, cardiologists, surgeons, and gynecologists. The clinical services offered by the Motility Lab will benefit numerous physicians and their patients.

IU University Hospital Motility Lab

  • Contact Information:

    Office: 317-948-8137, Fax: 968-1066
    Ordering form for Motility Lab

  • Esophagus testing
    • High Resolution Esophageal Impedance-Manometry

      This test uses a solid-state combined impedance (measuring resistance) and manometry (measuring pressure) catheter with 32 circumferential pressure sensors and 16 impedance sensors to cover the entire esophagus. It measures the strength and function of the muscles in the esophagus to evaluate the cause gastroesophageal reflux disease or GERD. The test is also used to determine the cause of problems with swallowing food, such as food or liquids getting stuck in the chest after swallowing and to evaluate patients with chest pain that may be coming from the esophagus rather than the heart. Finally, the test may be needed to correctly place an acid-sensing probe (pH probe) in the esophagus.
      Patient preparation and instructions

    • Bravo esophageal pH wireless monitoring

      Wireless pH (acid) monitoring, usually placed during an upper endoscopy, but can be placed with a documented GE junction measurement. It does not require placing a tube through the nose. This test determines the effectiveness of medications that prevent acid reflux by measuring the amount of acid refluxing or backing up from the stomach into the esophagus. But it does not measure non-acid reflux. Patient preparation and instructions

    • Ambulatory esophageal pH and impedance monitoring

      Catheter-based ambulatory monitoring to quantify acid and non-acidic gastro-esophageal reflux. It is used to evaluate for gastroesophageal reflux disease and to determine the effectiveness of medications that prevent acid reflux and as part of a pre-operative evaluation before anti-reflux surgery. Patient preparation and instructions

  • Stomach and small bowel testing
    • Antroduodenal manometry

      This catheter test provides information regarding the muscle and pressure activity of the stomach and small bowel to determine what area of the digestive tract is not working properly - the stomach, the small intestine or both. It requires special placement into the small intestine. Patient preparation and instructions

    • Hydrogen breath testing:

      This is a simple breath test to measure carbohydrate (milk and sugars) malabsorption or small intestinal bacterial overgrowth. There are four ways to do the test, based on what the doctor is looking for and what test challenge the patient takes in:

      • Hydrogen breath test with lactose to detect lactose intolerance, which can cause abdominal cramps and diarrhea when one consume lactose products (milk, ice cream, cheese, yogurt).
      • Hydrogen breath test with fructose to detect fructose intolerance, which can cause abdominal cramps and diarrhea when one consume high fructose products (soda or processed foods high in fructose corn syrup).
      • Hydrogen breath test with glucose to detect small intestinal bacterial overgrowth, which can cause abdominal cramp, diarrhea, weight loss, food malabsorption.
      • Hydrogen breath test with lactulose to detect small intestinal bacterial overgrowth, which can cause abdominal cramp, diarrhea, weight loss, food malabsorption. Lactulose can be used instead of glucose in patients with diabetes.
      Patient preparation and instructions

       

    • Gastric neurostimulator check with or without reprogramming:

      This test evaluates the function of the gastric electrical stimulator in patients with severe gastroparesis.

    • Electrogastrography with provocation (EGG):

      It provides information on electrical activity of the stomach, which is commonly abnormal in patients with nausea and vomiting.

      Patient preparation and instructions

       

  • Colorectal and pelvic floor testing
    • High resolution anorectal manometry and rectal compliance/sensation:

      This test uses a solid-state catheter with 23 sensors and a balloon in the rectum to study the anal sphincter strength and relaxation, defecating coordination, rectal compliance (tension), and sensation. It is commonly done on patients who suffer from constipation or fecal incontinence (leakage of stool). This test measures the pressures of the anal sphincter muscles, the sensation and muscle tension in the rectum, and the neural reflexes that are needed for normal bowel movements.

      Patient preparation and instructions

       

    • SmartPill study (Wireless whole gut transit/motility capsule):

      The SmartPill is a single-use capsule that uses wireless sensor technology to measure pressure, pH, and temperature throughout the entire digestive tract. After swallowing SmartPill capsule with an energy bar, the capsule travels through the digestive tract. It collects data and sends it to a wireless data receiver, worn on a belt. After five days, the patient the data receiver to download the data to a computer. SmartPill testing measures the total and segmental transit times and pressures throughout the entire GI tract. It is used in patients who suffer from constipation and symptoms possibly related to slow emptying of the stomach and small intestine. Patient preparation and instructions

  • Other test available
    • Videocapsule capsule endoscopy:

      This is a small wireless camera (capsule) that one can swallow to visualize the entire small intestine. This test examines the lining of the middle part of the gastrointestinal tract, which includes the three portions of the small intestine (duodenum, jejunum, ileum), which cannot be reached by traditional upper endoscopy or by colonoscopy. The most common reason for doing capsule endoscopy is to search for a cause of bleeding from the small intestine. It may also be useful for detecting polyps, inflammatory bowel disease (Crohn’s disease), ulcers and tumors of the small intestine. Patient preparation and instructions

IU North Hospital Motility Lab

  • Contact Information
  • Esophagus testing
    1. High Resolution Esophageal Manometry [description]

      [Patient preparation and instructions]

    2. Bravo esophageal pH wireless monitoring [Description]

      [Patient preparation and instructions]

    3. Ambulatory esophageal pH and impedance monitoring [Description]>

      [Patient preparation and instructions]

Motility Clinics

The Motility Clinic is a comprehensive referral center for the evaluation and treatment of patients with GI motility and functional bowel disorders, such as achalasia, gastroesophageal reflux, gastroparesis, functional dyspepsia, irritable bowel syndrome, constipation, and fecal incontinence. We offer extensive services only available at a nationally recognized hospital level, including:

  1. Gastric electrical stimulation for gastroparesis (temporary and permanent)
  2. Medical and surgical treatment of complex esophagus and foregut disorders
  3. Multidisciplinary approach to anorectal and pelvic floor disorders
  4. Other therapies available under clinical research trials

View IU Motility Clinic Locations in a larger map

(1) IU University Hospital, MDC Clinic
550 N University Ave
Indianapolis, IN 46202
(2) IU North
11700 N. Meridian St
Carmel, IN 46032
(3) IU Saxony
13000 E 136th St
Fishers, IN 46037
Disorders and Treatments
  • General GI Motility
  • Esophagus and swallowing disorders
  • Eosinophilic esophagitis
  • Gastroparesis
  • Gastric electrical stimulation for severe gastroparesis:
    1. Gastroparesis is an illness caused by a delay of stomach emptying. Symptoms include nausea, vomiting, weight loss, bloating, epigastric pain and effortless regurgitation of undigested foods. In some patients, symptoms are severe with vomiting and dehydration requiring intravenous fluids, multiple hospitalizations, and small bowel feeding tube to maintain adequate nutrition. The number of hospitalizations from gastroparesis is increasing. Currently, the medical treatment for gastroparesis is inadequate.
    2. Gastric electrical stimulation (GES) has become an effective therapy for selected patients with refractory gastroparesis. Vomiting and quality of life significantly improve in long-term follow-up studies. Health care utilization and hospitalization diminish with GES implantation compared to medical therapy. Patients with diabetic gastroparesis respond better than gastroparesis from other causes. However, majority of patients with gastroparesis are not diabetic. It is often difficult to predict who will or who will not benefit from GES.
    3. Temporary GES is safe and effective therapy for gastroparesis. Using routine upper endoscopy, electrodes are attached to the mucosal surface of the stomach with two small caliber leads through the nose. Temporary GES can be achieved for a week. During this “test” period, stimulation is adjusted to determine the optimal setting to normalize gastric electric rhythm and maximize symptom improvement. In patients with unclear benefit, temporary GES can predict response to long term GES. Patients, who do not respond to temporary GES, do not need to undergo unnecessary surgery.
  • Constipation and pelvic floor disorders
  • GI behavior services
[Description of research interests within the unit]
Clinical Research
i) [Contact information for potential subjects] ii) Active research studies (1)[List each study with link to its clinicaltrail.gov]
Translational Research
i) Small Intestinal Bacterial Overgrowth
For Patients
      1. Patient Information on Motility Conditions
        1. Esophagus Disorders
          1. Achalasia
          2. Barrett’s esophagus
          3. Eosinophilic esophagitis and swallowed steroid therapy
          4. Gastroesophageal reflux disease (GERD)
          5. Laryngopharyngeal reflux disease (LPR)
          6. Surgical therapy for GERD
          7. Endoscopic therapy for GERD
        2. Stomach and Small Bowel Disorders
          1. Gastroparesis
          2. Dietary and lifestyle recommendations for gastroparesis
          3. Frequently-Ask-Questions: Stomach Stimulator for Gastroparesis
          4. Small Intestinal Bacterial Overgrowth
          5. Low FOMOP Diet for Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome
        3. Colorectal and Pelvic Floor Disorders
          1. Irritable bowel syndrome
          2. Fecal incontinence
          3. Kegel exercises
          4. Low residual diet
          5. Constipation
          6. Management of intestinal gas
      2. Links for more information and patient support groups
        1. http://www.iffgd.org/
        2. http://g-pact.org/
        3. http://www.cvsaonline.org/
For Physicians and Researchers
Events Calendar