In normal digestion, food is moved
through the digestive tract by rhythmic contractions called peristalsis.
When someone suffers from a digestive motility disorder, these contractions
(GI) motility is defined by the movements of the digestive system
and the transit of the contents within it. When nerves or muscles
in any portion of the digestive tract do not function with their
normal strength and coordination, a person develops symptoms related
to motility problems.
disorder can be due to one of two causes:
- A problem within the muscle itself.
- A problem with the nerves or hormones that control the muscle's
Each part of the GI tract esophagus, stomach, small intestine
and large intestine has a unique function to perform in digestion
and each has a distinct type of motility and sensation. When
motility or sensations are not appropriate for performing this
function, symptoms occur.
The Small Intestine
- Intestinal Dysmotility, Intestinal Pseudo-Obstruction
- Small Bowel Bacterial Overgrowth
The Large Intestine (Colon)
- Irritable Bowel Syndrome (IBS)
Gastrointestinal motility disorders may be associated with the following
Irritable bowel syndrome
Gastro paresis — paralysis of the stomach.
Esophageal spasms — irregular contractions of the muscles
in the esophagus.
Hirschsprung's disease — a congenital disorder in which
poor motility causes obstruction of the large intestine.
Chronic intestinal pseudo-obstruction — a rare disorder
of the muscles and nerves in the intestine.
Scleroderma — a progressive hardening and scarring of
the skin and connective tissues.
Achalasia — an esophageal motility disorder.
treatment options include: lifestyle changes (increasing water
and dietary fiber intake; daily exercise), bulking agent laxatives,
stool softening laxatives, osmotic laxatives stimulant laxatives.
The main intervention is to increase the intake of water and
dietary fiber. The latter may be achieved by consuming more
vegetables and whole grain bread. The routine use of laxatives
is discouraged as this may result in bowel action becoming dependent
upon their use. Exercise has been shown to stimulate bowel motility.
Because several different drugs can cause intestinal motility
disorders, avoiding them, if possible, may resolve the condition.
In patients with primitive intestinal motility disorders, the
administration of some drugs may be useful to control symptoms.
Broad-spectrum antibiotics may be needed to control bacterial
the patient is unable to maintain adequate nutritional intake
or continues to have severe symptoms despite palliative treatment,
long-term home parenteral nutrition may be necessary. Many patients
on home parenteral nutrition seem to do well, although some
develop sepsis and thrombotic complications.
Changes in dietary habits alone can help cure motility disorders.
Correct fiber intake is useful in patients with either constipation
or stool leakage. Fiber and water must be abundant in the diet
of patients with constipation. Patients should avoid fermentable
Patients should take small frequent meals (6-8 times/d), avoid
foods high in fat or lactose and avoid residue- and gas-producing
foods. Consultation with a dietitian helps provide the patient
with a number of options.
Mild physical exercise is not contraindicated and may be very
useful for symptom relief in patients with IBS or constipation.