Esophageal Motility Disorders: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Esophageal Motility Disorders?
A gastroenterologist, a doctor who treats digestive problems, usually evaluates esophageal motility disorders. These are problems with how the muscles of the esophagus move food. A surgeon may help with severe cases. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What are esophageal motility disorders?
Motility means movement. The esophagus is the tube that carries food from your mouth to your stomach. Esophageal motility disorders are problems with how the muscles of the esophagus move food along. Two examples are achalasia and esophageal spasms. In achalasia, the lower muscle in the esophagus does not relax like it should. The normal muscle activity of the esophagus, called peristalsis, is also reduced or absent. Esophageal spasms are muscle contractions that cause chest pain or swallowing problems. Achalasia is rare.
Symptoms
Symptoms can be different for each condition. They may include:
- Trouble swallowing or feeling like food is stuck.
- Regurgitation, which is food or liquid coming back up into your mouth.
- Pain in your chest, belly, or back.
- Heartburn, a burning feeling in your chest or throat.
- Losing weight without trying.
Trouble swallowing liquids but not solids may point to nerve damage or spasm of the esophagus. Trouble swallowing only solids may point to a blockage, such as a stricture or a tumor. A stricture is a narrowed area. Without treatment, some disorders may lead to other problems, such as pneumonia from food entering the windpipe.
Causes and who gets it
The cause depends on the type of disorder. Some run in families, and others are linked to allergic reactions to food or substances in your environment. Achalasia is caused by damage to the nerves of the esophagus. It may occur at any age but is most common in people ages 25 to 60. In some people, achalasia may be inherited. You may be more likely to develop an esophagus disorder if you are overweight, are pregnant, or take certain medicines. GERD, Barrett's esophagus, and achalasia can also raise your risk for esophageal cancer.
How doctors diagnose it
Your health care provider will ask about your symptoms and medical history. Tests may include:
- Upper GI endoscopy, which uses a tiny camera to look inside your esophagus and stomach.
- A biopsy, which takes a small tissue sample to check.
- A barium swallow, which uses imaging to see how you swallow.
- Esophageal manometry, which checks how well your esophagus moves food to your stomach.
- An esophageal pH test, which measures how often acid backs up into your esophagus.
For achalasia, a test called FLIP makes a detailed picture of how your esophagus moves.
Treatment
Treatment depends on what is causing the problem and your overall health. Some esophagus disorders get better with over-the-counter medicines, diet changes, or lifestyle changes. Others may need prescription medicine or surgery. Your provider may suggest changes to your diet. You may need to learn new chewing and swallowing techniques. For achalasia, treatment aims to lower the pressure at the sphincter muscle so food and liquids pass easily into the stomach. The sphincter is the ring of muscle between the esophagus and stomach.
Achalasia treatment may include:
- An injection of botulinum toxin (Botox) may help relax the sphincter muscles, but it wears off within weeks or months.
- Medicines such as long-acting nitrates or calcium channel blockers can relax the lower sphincter. They are rarely a long-term solution.
- Surgery called a myotomy, which cuts the lower sphincter muscle.
- Widening of the esophagus with a balloon during an EGD.
When to see a doctor
Contact your provider if swallowing problems do not improve after a few days, or if they come and go. Contact your provider right away if you have a fever. Do the same if you are losing weight or your swallowing problems are getting worse. Call 911 or go to the emergency room for chest pain that lasts two minutes or more, trouble breathing, choking, fainting, or coughing or vomiting blood. Pain in your jaw or arm can also be a heart problem, so get help right away.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Such a doctor can review your swallowing symptoms, arrange first tests, and refer you to a gastroenterologist for specialist testing and treatment.
Common questions
Can esophageal motility disorders cause chest pain?
Yes, some of them can. Esophageal spasms are muscle contractions that cause chest pain or swallowing problems. Chest pain can also be a sign of a heart problem, so call 911 or go to the emergency room if it lasts two minutes or more.
Does achalasia raise the risk of esophageal cancer?
Yes, achalasia can raise your risk for esophageal cancer. GERD and Barrett's esophagus can also raise that risk.
Can lifestyle changes help esophagus symptoms?
Yes, they can help for some people. You can help prevent or reduce symptoms by not smoking and limiting alcohol. Other steps are eating smaller meals, avoiding eating close to bedtime, and wearing loose-fitting clothes.
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Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
