What Causes Gastrointestinal Motility Disorders?

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In normal digestion, food is moved through the digestive tract by rhythmic contractions called peristalsis. This movement is called "gastric motility." When someone suffers from a digestive motility disorder, these contractions don't work the way they should, potentially leading to a variety of problems.

Intestinal walls consist of layers of muscles. In normal conditions, these muscles contract and relax in a coordinated, rhythmic fashion that propels food from the esophagus to the stomach, and through the intestine to the anus.

But in the presence of a motility disorder, these contractions don't occur in a coordinated fashion. This results in food not passing through the intestine properly.

Gastrointestinal motility disorders may cause a wide range of digestive symptoms, including: difficulty swallowing, gastrointestinal reflux disease (GERD for short), gas, severe constipation, diarrhea, abdominal pain, vomiting, and bloating.

The problem with your digestive muscles can be due to one of two causes:

  • a problem within the muscle that controls peristalsis
  • a problem with the nerves or hormones that govern the muscle's contractions

However, there are many conditions that can cause problems with either your digestive muscles or in the nerves that control them. If you're having symptoms of a digestive motility disorder, you should see your doctor to get a proper diagnosis, since treatment will differ depending on the cause of your problem.

Conditions Associated with Gastric Motility Disorders

There's a variety of different digestive and non-digestive conditions that are associated with gastrointestinal motility disorders. Here are eight of them:

  1. Irritable bowel syndrome. IBS is considered a "functional" digestive condition, which means it affects how your digestive system works, but doesn't damage the organs themselves. When you have IBS, your digestive motility is altered — it's either faster or slower, leading to either diarrhea or constipation. The abnormal muscle contractions also cause pain.
  1. Gastroparesis. This is what's called "delayed gastric emptying" — in other words, a stomach that's slow to empty itself. Your stomach muscles govern the movement of partly digested food through your stomach and into your small intestine. When the nerve that controls those muscles is damaged or isn't working properly, the food moves too slowly. In most cases of gastroparesis, doctors can't identify the cause.
  2. Diabetes. You probably don't think of diabetes as a condition that affects your digestive system, but in fact about half of people with diabetes also have gastroparesis — diabetes is the most common known cause of that gastric motility disorder. High blood sugar levels may be to blame for the problem.
  3. Esophageal spasms. These are irregular contractions of the muscles in your esophagus, which is the tube that carries your food from your mouth down to your stomach. It's not clear why these irregular contractions occur, although in some people, food that's too hot or too cold can trigger them. The pain of esophageal spasms can be mistaken for heart-related pain, which is why you should have a doctor check it out.
  1. Hirschsprung's disease. This is a congenital disorder in which poor digestive motility causes a blockage in the large intestine. It's far more common in boys than in girls, and it's sometimes linked to other major inherited conditions, such as Down's syndrome.
  2. Chronic intestinal pseudo-obstruction. This is a rare condition with symptoms that make it look as though your large intestine is blocked, even though it's not. Instead, problems with the nerves that control your digestive muscles are to blame.
  3. Scleroderma. Scleroderma, an autoimmune disease, involves a tightening of the skin and connective tissues, but it also can affect your digestive system. GERD and intestinal pseudo-obstruction are common in people with scleroderma.
  4. Achalasia. This condition involves the ring of muscle at the bottom of your esophagus, where your esophagus empties into your stomach. When you have achalasia, this ring fails to relax properly during swallowing, so food doesn't move as easily from your esophagus into your stomach. The condition is due to nerve damage.

Sources:

Abrahammson H. Gastrointestinal motility disorders in patients with diabetes mellitus. Journal of Internal Medicine. 1995 Apr;237(4):403-9.

Lind CD. Motility disorders in the irritable bowel syndrome. Gastroenterology Clinics of North America. 1991 Jun;20(2):279-95.

National Institute of Diabetes and Digestive and Kidney Diseases. Gastroparesis fact sheet. Accessed March 27, 2016.

National Institute of Diabetes and Digestive and Kidney Diseases. Intestinal pseudo-obstruction. Accessed March 27, 2016.

Sjogren RW. Gastrointestinal motility disorders in scleroderma. Arthritis and Rheumatism. 1994 Sep;37(9):1265-82.

U.S. National Library of Medicine. Achalasia fact sheet. Accessed March 27, 2016.

U.S. National Library of Medicine. Esophageal spasm fact sheet. Accessed March 27, 2016.

U.S. National Library of Medicine. Hirschsprung's disease fact sheet. Accessed March 27, 2016.

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