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Programs and Services

Motility Clinic

At Phoenix Children’s, we offer several programs and services to diagnose and treat motility disorders. These include biofeedback training and tests to evaluate gastrointestinal tract structures and function. We also offer procedures to stretch the esophagus or anus if either is too narrow to function properly.

Diagnostic procedures include:

  • Anorectal manometry: A test used to evaluate the nerve and muscle function in the rectum and anus. This test is often performed on patients with stool incontinence (inability to control bowel movements) or chronic constipation. An anorectal manometry exam takes 45 minutes to perform. No anesthesia is required, and patients go home the same day.
  • Antroduodenal manometry: A test to study the function of the upper intestine (stomach and small bowel). This test is often used to evaluate patients who have gastroparesis (delayed emptying of the stomach). During this study, an endoscope tube is used to place a catheter in the upper intestine. Doctors use the catheter to measure function. Antroduodenal manometry exams take several days and requires a hospital stay.
  • Colonic manometry: A test used to measure the function of the colon. This test can help doctors understand the cause of chronic constipation and stool incontinence. During this test, doctors perform a colonoscopy to place a catheter inside the colon. This catheter measures colon function. Colonic manometry exams take several days and requires a hospital stay.
  • Esophageal manometry: A test to evaluate the function of the muscles in the esophagus. This test may be used to help in the diagnosis of swallowing dysfunction and gastroesophageal reflux (GERD). Esophageal manometry exams take about 45 minutes. No anesthesia is required, and patients go home the same day.

Biofeedback Therapy for Constipation

Many children struggle with chronic constipation — constipation lasting six months or longer. For some children, constipation is caused by problems with the way their rectum or anus develops at birth. For others, constipation is a result of waiting too long to use the bathroom. When children “hold it” too long, they get used to constantly squeezing the muscles in their anus that should relax during a bowel movement.

At Phoenix Children’s, we offer anorectal biofeedback for the treatment of chronic constipation. This therapy uses a device to measure how muscles respond to electrical stimulation. Our team incorporates video games into biofeedback therapy to teach children correct muscle control.

EndoFlip and EsoFlip

Children with motility problems in their esophagus may benefit from EndoFlip or EsoFlip evaluations.

EndoFlip, like esophageal manometry, allows physicians to measure the function of the muscles in the esophagus. EndoFlip is performed under anesthesia. This procedure is especially helpful in diagnosing narrowing of the esophagus (stricture), GERD and achalasia.

During EndoFlip, a catheter is placed through the mouth and into the esophagus. Doctors inflate a balloon on the body of the catheter. This allows them to measure the size and pressure inside the esophagus. 

EsoFlip can be used to treat certain conditions of the esophagus. During EsoFlip a balloon is used to dilate (stretch) the esophagus.

Pelvic Floor Physical Therapy

What is Pelvic Floor Physical Therapy?

Pediatric pelvic floor physical therapy is a specialized therapy that focuses on pelvic conditions and symptoms for children from birth to 17 years. This type of physical therapy assists in retraining muscles in and around the pelvis to restore function.

What is the pelvic floor and why is it important?

The pelvic floor is a group of muscles located in and around the pelvis. These important muscles provide support for the pelvic organs and core. They work to help control urinary and bowel functions. The pelvic floor muscles are like any muscles in the body and can become tight, weak, go into spasm, or have poor coordination. Bowel and bladder issues or pelvic pain can occur when these muscles are not working properly.

What to expect in a treatment session:

A physical therapist specialized in treating pelvic floor conditions will meet with you and your child during the initial consultation. During the first session, your child’s medical history, symptoms, and goals will be discussed. The consultation may include examination of your child’s strength, range of motion, muscle flexibility, posture, movement patterns, and pelvic and core stability. If needed, an external non-invasive examination of the pelvic floor muscles will be completed to assess function. The information gathered will help determine what treatment interventions to include in your child’s plan to improve their condition.

Treatments are 1:1 and individualized to focus on the child and family concerns to improve quality of life. If treatment is indicated, additional sessions are typically scheduled for one hour a week for 6-12 weeks.  

What is Pelvic Floor Biofeedback?

Children who have conditions that affect the bladder or bowels may benefit from a specialized treatment called pelvic floor biofeedback. Pelvic floor biofeedback is non-invasive and is used to help teach the child how to strengthen or relax their pelvic floor muscles. Biofeedback helps patients bring awareness and control to this group of muscles.

Pelvic floor biofeedback uses external sensors to record activity of the pelvic floor muscles and produces a visual representation of muscle activity. When your child can visualize their muscle activity with assistance from a Physical Therapist, it can help them identify and change how those muscles are used.

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