Motility disorders are conditions associated with the esophagus, stomach, small intestine, colon, and anus or rectum. In a healthy child, wave-like contractions called peristalsis move food through the intestinal tract. These contractions also help the body absorb nutrients. Peristaltic contractions happen when the muscles and nerves of the digestive tract work together.

If a child has a motility disorder, the muscles and nerves of the digestive tract do not work together in a coordinated way. This prevents food from properly moving through the digestive system.

What are symptoms of motility disorders?

If a child has problems with the function of the muscles or nerves of his digestive tract, it can cause a variety of motility issues, including:

  • Abdominal pain or distension (bloating)
  • Aspirating (inhaling liquid into the lungs)
  • Chest pain
  • Choking
  • Constipation
  • Diarrhea
  • Difficulty swallowing
  • Gagging
  • Incontinence or soiling
  • Regurgitation (bringing undigested food up from the stomach to the mouth)
  • Vomiting
  • Weight loss

How do I know if my child needs to be seen in a motility clinic?

Talk to your child’s doctor to help decide whether the Children’s Healthcare of Atlanta Neurogastroenterology and Motility Clinic is right for your child’s needs. If so, your child’s doctor can make a referral.

Common conditions we treat in our Neurogastroenterology and Motility Clinic include:

  • Achalasia
  • Anorectal malformations
  • Chronic intestinal pseudo-obstruction
  • Dysphagia
  • Ehlers-Danlos syndrome, Type III
  • Fecal incontinence
  • Functional abdominal pain
  • Gastroesophageal reflux disease (GERD)
  • Gastroparesis
  • Hirschsprung’s disease
  • Imperforate anus
  • Intractable constipation
  • Irritable bowel syndrome (IBS)
  • Motility disorders
  • Recurrent vomiting
  • Rumination
  • Spina bifida
Children’s has one of the most advanced pediatric motility programs in the country. In addition to intensive one-on-one outpatient visits, we utilize state-of-the-art technology to help diagnose conditions and guide care. These include:

During this procedure, a small catheter with extremely sensitive sensors is placed into your child’s anus to assess the sensation of his nerves and function of muscles when he poops. We assess for specific reflexes in the rectum by asking your child to push and squeeze his bottom like he’s having a bowel movement while we inflate a small balloon.

If your child has had surgery for conditions like Hirschsprung’s disease or imperforate anus, our 3D technology can digitally re-create the muscles in his anus to better assess whether he’s using them effectively.

This is the gold standard to assess the function of the esophagus. A catheter is placed through your child’s nose and down his esophagus into his stomach. Your child will most likely be awake for the placement, and our motility nurses will help guide him through the process. He will be asked to consume liquids, pastes and solids to assess how well he swallows and how well his esophagus works.

Currently, we are the only pediatric hospital in the Southeast to offer these tests for children. They assess the functionality of the small and large intestines. After an intensive outpatient visit, your child will be required to spend two to three days in the hospital.

During hospitalization, your child will undergo either an endoscopy or colonoscopy. Specialized catheters will be placed while your child is asleep. Our motility team and highly qualified nursing staff will follow a very precise protocol to assess the function of your child’s intestines and help make sure he receives the best possible care during his stay.

For children with severe constipation who do not respond to medicine, Botox can be injected into the anus to help relax the muscle. If a child has certain feeding difficulties, Botox can also be injected into the pylorus (muscle that separates the stomach from the small intestine) to help it relax and allow food to pass.

Our neurogastroenterology and motility team specializes in these techniques and only offers these treatments when medically necessary.

Reflux can be a challenging diagnosis, even for pediatric gastroenterologists. This test allows our team to assess if your child has reflux and whether his reflux or regurgitation needs specialized intervention.

At Children’s, each pH impedance test is reviewed by Jose Garza, MD, a Pediatric Neurogastroenterologist.

Teddy’s progress with a chronic condition

Born with Hirschsprung’s disease, Teddy has been in and out of the hospital since he was born. Today, however, he is performing and going to school like a typical 4-year-old.


The Children’s Neurogastroenterology and Motility Program is led by one of the only pediatric neurogastroenterology and motility experts in the region, Jose Garza, MD. Dr. Garza is a board-certified pediatric gastroenterologist who has advanced training in pediatric motility disorders.

  • Jose Garza, MD, Medical Director, Neurogastroenterology and Motility Program
  • Christie Azpeitia, RN
  • Jessica Buzenski, PhD, GI psychologist
  • Nancy Morris, LPN
  • Lisa Parr Sitz, CPNP

Our Neurogastroenterology and Motility Clinic is located on the sixth floor of the Center for Advanced Pediatrics.

Center for Advanced Pediatrics
2174 North Druid Hills Road NE
Atlanta, GA 30329