Pediatric Motility Disorders Program

If your child has been diagnosed with a serious gastrointestinal disorder or feeding intolerance and has not responded to previous treatment or medication our team help. We offer complete care for common and complex motility disorders — care that's hard to find elsewhere. We can help with a range of conditions including chronic pseudo intestinal obstruction, gastroparesis, intractable nausea and vomiting, encopresis, esophageal dysmotility, internal anal sphincter, achalasia, pyloric sphincter, esophageal sphincter, chronic intractable abdominal pain, affecting how food moves through the digestive system.

We're also committed to your child's health and well-being. We're ready to answer all of your questions and provide any support your family needs.

Choosing our center for pediatric motility disorders

Each year, more than 1,000 children and their families turn to our team for care. They do so because we provide answers regarding a wide range of motility disorders. These conditions include gastroesophageal reflux disease (GERD), constipation and irritable bowel syndrome (IBS).

When you visit Cook Children's, you'll find:

Expertise: Cook Children's is one of a limited number of pediatric medical centers offering specialized care for motility disorders. Our program director, Bankole Osuntokun, M.D., is a pediatric gastroenterologist with additional training in motility disorders. Our team partners with others experts in pediatric surgery, interventional radiology, pain management, ear, nose and throat care, as well as pulmonology to provide comprehensive help for your child. Meet our GI team members.
Full range of care: We have the skill and experience needed to accurately perform the most advanced diagnostic tests. We also offer a full range of treatments, from standard approaches such as medication and surgery to the latest therapies accessed through our clinical trials program.
Convenient and timely access: While all testing is performed at our main medical center in Fort Worth, you'll be able to access follow-up care at locations throughout the Metroplex. We're committed to getting your child the care they need. You can contact your care team any time by phone or through our MyCookChildren's patient portal with questions or concerns.
Special help for older teens: As teens with chronic conditions approach adulthood, we'll help them learn how to manage their health. When they're ready, we help them seamlessly transition their care to a motility specialist who treats adults.

Full support for children with motility disorders

In addition to our doctors and nurses, our team includes dedicated experts who support your child throughout treatment. These specialists include:

Dedicated nurse coordinator: Our nurse coordinator works closely with your family to schedule appointments, including for care with other Cook Children's specialists. If you're traveling from far away, our coordinator can help you find nearby accommodation.
Child Life specialists: Our Child Life specialists help your child understand what to expect during testing and treatment. They use models and diagrams to explain care in terms your child can understand. They also provide activities to make your child more comfortable during clinic visits.
Clinical therapists: Our clinical therapists are a key part of our care team. They help your child cope with managing a motility disorder. And don't be surprised if your child gets a visit from a furry friend. Our therapy dog frequently drops in for a visit.
Dietitians: Our dietitians make sure your child gets the nutrition needed to grow and develop. They'll recommend nutritional supplements or create a diet tailored to your child's needs.
Rehabilitation therapists: Physical, occupational and speech therapists offer treatment for children with feeding or swallowing disorders.
Social workers: Our social workers ensure you have everything you need. They can help connect you with community resources and support groups.

Motility disorders treated

We treat the full range of motility disorders, including:

Achalasia
Constipation
Encopresis
Delayed gastric emptying
Fecal incontinence
Functional abdominal pain, Gastroesophageal reflux (GERD)
Hirschsprung's disease
Intestinal pseudo-obstruction
Irritable bowel syndrome
Problems following fundoplication, Dumping syndrome
Postoperative problems following GI surgery
Imperforate anus
Myelomeningocele and other neurologic conditions that lead to fecal incontinence and constipation
Atypical symptoms of gastroesophageal reflux
Intractable nausea and vomiting
Tracheo-esophageal fistula constipation and IBS.

Diagnosing troubles with swallowing or digesting food

Muscles and nerves work throughout our digestive tract to move food through our body. This process is called motility. If an area of the digestive system doesn't function properly, it can cause symptoms such as trouble swallowing, gastric reflux or constipation.

We use the latest technology to diagnose children with motility disorders and provide relief. We start, though, with the basics. We review medical records once you or your doctor contact us. At the first appointment, we do a physical exam and ask about symptoms.

We then discuss our advanced testing options with you. For some procedures, we give your child sedation. You can take your child home the same day of the test.

We offer a full range of motility testing, including:

Advanced endoscopy: Helps us see real-time pictures of the tissues and organs in the digestive system and provide care for a range of GI disorders. This testing gives the doctor a detailed view of the digestive tissue, without surgery.
Antroduodenal manometry: The purpose of this test is to determine how well the muscles of the antrum and the duodenum are working. A small flexible tube is placed through the nose or an existing g-tube into the stomach and small intestine.
Colonic manometry: This test helps us diagnose children with colonic dysmotility, constipation and leaky stools. It measures the strength of muscle contractions in the large intestine. While the child is under general anesthesia, a flexible tube is inserted into the child's colon, but the test is completed when they are awake.
Endoscopy: For these minimally invasive procedures, we use a thin, flexible tube called an endoscope to look inside the digestive tract. The tube has a camera or ultrasound probe attached at the end. We carefully thread the tube into the throat, nostrils or other natural openings. We can then see real-time pictures of tissue and organs throughout the digestive system.
Endoluminal functional lumen imaging probe: During endoscopy, we may also use a special tube (catheter) fitted with a balloon-shaped device to measure distance and pressure inside various organs in the digestive system. For example, we can examine the esophagus and identify why a child is having difficulty swallowing.
Esophageal pH probe studies: This test uses a thin probe gently placed through the nostrils and into the lower section of the esophagus. It measures the pH level of stomach acid. It can also examine how often stomach acid moves into the esophagus and how long it stays there.
High-resolution manometry testing: We use this testing to measure the strength and pressure of the muscles in various areas of the digestive system. It helps us understand how food is moving through the digestive tract. Learn more about anal manometry [PDF] and esophageal manometry [PDF].
Imaging: We use scans such as CT and MRI to examine organs and structures in the digestive tract. We may also use magnetic resonance elastography (MRE), essentially a special type of MRI for the intestines.
Sitz marker test: To measure how fast food moves through the intestines, we use a test called the Sitz marker. Patients start by swallowing a tiny capsule that contains radio markers. A few days later, we take an X-ray to see if there are traces of the markers in the intestines.

Treating motility disorders in children

After diagnostic testing is complete, we develop a treatment plan to meet your child's needs. We keep your child's pediatrician updated throughout treatment and coordinate follow-up care if needed.

We offer a full range of treatments, including:

Nutritional support: Our dietitians work with you and your child to create a diet tailored to your child's needs. If necessary, we can recommend vitamins or other nutritional supplements to support your child's growth.
Botulinum toxin (Botox®) injections: With these treatments, we gently inject medicine to relax muscles in areas of the digestive tract. These treatments can help food and liquid move more easily through the digestive system.
Esophageal, pyloric and anal dilation: For these procedures, we carefully insert an endoscope into the digestive tract. The tube has a camera and a balloon-shaped device attached. We use this device to enlarge narrowed areas throughout the digestive system. Learn more about advanced endoscopy.
Feeding tube placement: Some infants and children with more complex conditions have trouble feeding or swallowing. If so, we may recommend temporary placement of a feeding tube. This option ensures that children get the nutrition they need. Children may have a feeding tube while also receiving other treatments for a motility disorder.

To provide procedures and surgeries for more complex conditions, we partner with specialists in:

Through our clinical trials program, we also offer access to the latest therapies for motility disorders.

Make an appointment or refer a patient

We're ready to help. If you'd like to schedule an appointment, refer a patient or speak to our team, call our offices at 682-885-1990.

Make an appointment MyCookChildren's portal

Learn more about appointments, insurance coverage and patient referrals.

Coming from outside of Texas?

Our team in Global Health Services supports families who travel to Cook Children's for medical care from across the country and around the world.

Our concierge service is here to help with every detail. We'll work with your family to:

Schedule appointments
Plan travel
Find accommodations
Offer financial counseling and insurance approvals
Arrange translation services

Please contact our Global Health Services care coordinator to arrange your visit to Cook Children's:

682-885-4685 phone
682-885-2557 fax
globalhealthservices@cookchildrens.org

We're here to help.

If your child has been diagnosed, you probably have lots of questions. We can help. If you would like to schedule an appointment, refer a patient or speak to our staff, please call our offices at 682-885-1990