Motility Disorders Program

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Program Leadership

Jaya Punati, MD

Director
Jaya Punati, MD, director of the Motility Program is an expert in the field of motility disorders.

She has been named to the “Best Doctors in America" list. Her main clinical focus is in pediatric gastrointestinal motility disorders including chronic intestinal pseudo-obstruction, Hirschsprung’s disease, gastroparesis, and chronic refractory constipation and encopresis. She specializes in manometry testing, including esophageal and gastric colonic anorectal testing.

Motility Team Members

  • Anne Austad, RN II
  • Clarise Okwach, RN II

 

Motility Disorders Program
In the Division of Gastroenterology and Nutrition at Children’s Hospital Los Angeles, we diagnose and treat an array of pediatric motility problems including intestinal pseudo-obstruction, irritable bowel syndrome, fecal incontinence and severe constipation. The program uses the most advanced techniques and procedures available to help children with these disorders.

Symptoms of Gastrointestinal Motility Disorders

Children suffering from gastrointestinal motility problems have a variety of chronic symptoms that can cause significant physical and emotional stress for both children and their parents. These symptoms include:

  • Abdominal discomfort
  • Abdominal distention
  • Difficulty swallowing
  • Vomiting

Motility Conditions

We perform testing to evaluate your child's condition and assist us in diagnosing a wide array of conditions including:

  • Achalasia
  • Chronic severe constipation
  • Encopresis
  • Feeding difficulties
  • Gastroparesis
  • Hirchsprung’s disease
  • Imperforate anus
  • Irritable Bowel Syndrome
  • Megacolon
  • Non-retentive fecal incontinence
  • Pseudo-obstruction
  • Rumination disorders
  • Swallowing problems
  • Unspecified functional motility disorders

Motility Testing

Much of the testing that we provide centers around manometry testing which assist us in diagnosing a wide array of gastrointestinal issues. During a manometry test, a thin catheter with sensors, similar to a feeding tube, is moved into the area of the digestive system that is going to be tested. The tiny sensors record the movements of your child's digestive tract. Depending on the type of testing being done, the catheters may be introduced with the help of endoscopy or radiology.

Once your child's test has been completed and they awaken from anesthesia, the catheter is attached to the manometry machine. The manometry machine records the intestinal rhythm over a period of 6-8 hours. The recording is then interpreted by our motility specialized doctors. On some occasions medications are administered so that the system can test the effects of various medication on the digestive system's movements. Use the links below to find out more about the type of test ordered for your child.

ANORECTAL MANOMETRY

Description:  This test allows for evaluation of anal sphincter function and tone as well as rectal compliance. The ability of the pelvic floor to squeeze and relax is also evaluated.

ANTRODUODENAL MANOMETRY

Time Period:  Testing lasts for 6-8 hours.
Description:  This test permits us to evaluate movements in the stomach and small bowel (or small intestines). The stomach and small bowel are evaluated during testing, in response to a meal and specific medications designed to help with gastrointestinal movement.

COLONIC MANOMETRY

Time Period:  Testing lasts for 6-8 hours.
Description:  This test allows us to evaluate movement in the colon, at the bottom of the large intestine, in response to a meal. It will also be used to measure your child's response to medication designed to stimulate movement of this area of the body.  

ESOPHAGEAL INTRALUMINAL IMPEDANCE MANOMETRY

Description:  This test allows us to detect acid reflux, as well as non-acid reflux and evaluate the associated symptoms such as cough and apnea that may result from these symptoms.

ESOPHAGEAL MANOMETRY

Time Period: Testing lasts for 10-20 minutes.
Sleep Status:  The test is done with the child awake and able to swallow.
Description:  Esophageal manometry testing permits us to evaluate swallowing difficulties and motility of the esophagus and lower esophageal sphincter function.