Motility and digestion

Motility and digestion

The speed of motility can be affected by a number of factors; for example, highly fatty food, because it takes longer to digest than foods lower in fat, can slow down motility and foods higher in magnesium and insoluble fibre can increase motility. Disruption to the speed of motility (ie, going too fast or too slowly) can cause digestive and food absorption problems; disruption occurs in IBS, for example.

In normal digestion, food is moved through the digestive tract by peristalsis. When someone suffers from a digestive motility disorder, these contractions are abnormal and peristalsis becomes impaired resulting in either hypomotility, hypermotility, or a combination of both. In some cases, peristalsis may be totally absent.

If you suffer with dodgy digestive motility, I might be able to help! Contact me.

Motility

Motility is the movement of the intestinal muscle; it is controlled and helped by:

  • CCK
  • The gastric-inhibitory peptide
  • Peristalsis
  • Stomach action
  • Segmentation (contraction and squeezing of food)
  • Sphincter contractions

Digestive motility diseases and disorders may affect any one portion or the entire digestive tract and occur in people in all weight and age ranges; they can be familial, caused by a disorder, or idiopathic. The diseases and disorders may be primary, meaning there is no underlying disease causing the problem, or secondary, when the motility problem occurs as a result of a disease or medical condition.

Digestive motility problems

Poor gut motility can be uncomfortable
Poor gut motility can be problemmatic – but there are often dietary solutions!

This 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 contractions

Impaired gastric peristalsis can lead to SIBO due to stasis of food and bacteria in the upper GI tract.

Small intestinal bacterial overgrowth (SIBO) is defined as the presence of excessive bacteria in the small intestine. SIBO is frequently implicated as the cause of chronic diarrhoea and malabsorption.

Patients with SIBO may also suffer from unintentional weight loss, nutritional deficiencies, and osteoporosis.

Gastrointestinal motility is controlled by the nerves and muscles within the gastrointestinal tract.  Nerve connections between the brain and the GI tract send messages in both directions; these messages modify not only GI motility, but also perceptions from the gut: whether the perceptions feel good or feel bad has important consequences on diet.

What affects motility

Motility can be affected by:

  • Gut state (including damage to nerves)
  • Thoughts
  • Sleeping and waking
  • Alcohol and opiates
  • Stress
  • Low serotonin levels
  • Infection and inflammation (eg, Crohn’s disease)
  • Genetic defects and acquired disorders

When there is a motility disorder, the following symptoms may occur:

  • Difficulty swallowing
  • Heartburn
  • Gas
  • Bloating
  • Nausea
  • Vomiting
  • Constipation
  • Diarrhoea

Digestive motility diseases may be neuropathic (where the disease affects the nerves of the digestive tract) and/or myopathic (where that the disease affects the muscles). These diseases and problems are all associated with motility problems.

  • Abdominal surgery
  • Achalasia
  • Chronic intestinal pseudo-obstruction
  • Diabetes
  • Dysphagia
  • Endocrine disorders
  • Gastroparesis
  • GERD
  • Hirschsprung’s
  • Irritable bowel syndrome
  • Laxative abuse
  • Lupus
  • Muscular dystrophy
  • Neurological disorders
  • Oesophageal spasms
  • Parkinson’s Disease
  • Scleroderma

NOTE: Prokinetic drugs can be prescribed; they enhance gastrointestinal motility by increasing the frequency of contractions in the small intestine or making them stronger, but without disrupting their rhythm. Dietary, sensory, psychological, and social factors (the ‘brain-gut connection’) may all influence the clinical response, so although the effects of prokinetic drugs on GI motility are predictable, the clinical response is not! Neither do these drugs treat abdominal pain or other sensations, so if a client can be treated through dietary changes, all the better.

Ginger: The study, Effects of ginger on gastric emptying and motility in healthy humans[i] concluded, ‘Ginger accelerates gastric emptying and stimulates antral contractions in healthy volunteers…’

IBS: The IFFGD, the International Foundation for Functional Gastrointestinal Disorders says, ‘There is no evidence that digestion of food is different in those with IBS compared to those without IBS. Diet, food and eating do not cause IBS. However, muscles and nerves are over-reactive in IBS. This can cause the bowel to over-respond to stimuli.’

Examples of stomach (gastric) motility disorders include:

  • Delayed gastric emptying (gastroparesis)
  • Rapid gastric emptying (dumping syndrome)
  • Functional dyspepsia.

In IBS, small intestine contractions are not well coordinated. As a result, food may stay in the same part of the intestine for too long, resulting in putrefaction. Occasionally, bacteria grow in the small intestine where they should not be, causing carbohydrate fermentation.

s, of mechanical motor function of the oesophagus, stomach, and intestines which, when severe, can interfere with digestion, absorption, nutrition, and waste elimination; at the severe end of the disease spectrum, they represent digestive organ failure.

References

[i] http://www.ncbi.nlm.nih.gov/pubmed/18403946

[ii] http://www.karger.com/Article/Abstract/99477

Picture: Commons Licence

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