Gastrointestinal (GI) motility refers to the muscle contractions of the intestines that push food downward through the digestive system (peristalsis). Abnormalities in the GI tract and dysfunction of motility can cause bloating, urgency to defecate, constipation, diarrhoea, pain and fullness.
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Types of gastrointestinal motility disorders include irritable bowel syndrome (IBS); gastro-oseophageal reflux disease (GERD); chronic intestinal-pseudo-obstruction (CIP); dysphagia (difficulty swallowing); delayed gastric emptying (gastroparesis); cyclic vomiting syndrome (CVS); and Hirschsprung's disease.
GI motility problems can affect the stomach, oesophagus, small intestine, large intestine and the rectal and/or pelvic floor region. Problems in each area vary in symptoms, diagnosed disorders and treatments.
There are various procedures gastroenterologists perform to diagnosis which GI motility disorder afflicts you. These tests include endoscopy, where a camera tube is inserted down your stomach; esophagram, a radiagraphic procedure that gives an image of your oesophagus; impedance, which involves a tube inserted through the nose and worn for 24 hours to measure pH and acid levels in the stomach; and esophageal manometry, where a tube is inserted through the nose and down the oesophagus to measure contractions of the oesophagus during a 30-minute period.
There is no pattern of triggers for many sufferers of GI motility disorders. A food previously enjoyed with no problem can trigger an attack at the next consumption. Pain can come on suddenly or be almost chronic. The lack of predictability can be almost as frustrating as the symptoms.
Treatment and Prognosis
Therapy for each condition is different and can include prescription drugs, lifestyle changes, monitoring and sometimes surgery. Some GI motility disorders are relatively easy to treat, while others, like IBS, will probably be a lifelong problem in the patient.
In 2006, Naveed Ahmad, Jeanne Keith-Ferris, Elizabeth Gooden and Thomas Abell, researchers at the Department of Medicine and Division of Digestive Disease at the University of Mississippi Medical Center in Jackson, Mississippi, undertook a study to determine the safety of domperidone, a medication that has been used for years to treat several gastrointestinal motility disorders. Domperidone has never been approved by the Food and Drug Administration for use in GI motility disorders, and many doctors stopped prescribing it based on data that suggested domperidone could increase the risk of cardiac arrest. The researchers determined that domperidone was beneficial for GI motility disorders, especially gastroparesis, and failed to find sufficient evidence to support the concern that domperidone can cause heart problems.
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