Quality in the Gastrointestinal Motility Laboratory

Gastrointestinal (GI) dysmotility and disorders of gut-brain interaction have a considerable impact on healthcare utilization prompting demand for GI motility testing. Typical GI motility laboratories offer the ability to assess a range of complaints including dysphagia, gastroesophageal reflux, constipation, and fecal incontinence via catheter-based manometry and pH testing. Some GI motility labs offer regional or whole-gut transit evaluation using breath-test or capsule-based transit testing. These tests provide the physiologic basis that guides medical (acid suppression, prokinetics, neuromodulation), surgical (anti-reflux and esophagogastric junction-directed operations), and pelvic floor physical therapy/biofeedback decisions. Given the complex patient population and challenges in management, recognizing the several components needed to establish an optimized GI motility lab is important to provide high-quality evaluations. This includes a balanced schedule, assembling a well-trained staff, creating an accessible physical space for patients and staff, having the necessary equipment to facilitate study protocols and allow for prompt interpretation, and overall focus on a patient-centered experience. These factors combined help increase study completion success rates and ensure the necessary information is available to inform treatment recommendations. This chapter provides a detailed overview of how to establish a high-quality GI motility laboratory.