What is Motility Disorder?
Motility disorders are conditions that affect the normal movement of the digestive system including the esophagus, stomach, small intestine, and large intestine. The food moves through the digestive system in 2 ways:(1)
- Peristalsis: This involves contracting and relaxing the longitudinal muscles of the digestive system
- Segmentation: It divides and mixes the food in the digestive tract
Motility disorders can lead to difficulty in swallowing, bloating, constipation, diarrhea, and other symptoms.
A healthy digestive system involves muscles and valves that move food from one part of the digestive system to another. The movement of these muscles is known as peristalsis and the valves prevent the backward movement of the food. In motility disorder, these movements are affected.
Some common motility disorders include:
The treatment of motility disorders depends on the underlying cause including dietary changes, medications, and surgery.
Types of Motility Disorder
The body’s digestive system is divided into the upper and lower section. The upper digestive tract includes the esophagus and stomach, while the lower part includes the intestine.
The conditions affecting the upper and lower digestive system are as follows.
Achalasia is a rare disorder of the esophagus.(2) It causes problems with pushing food downward toward the stomach when the esophagus is relaxed.
The exact cause of achalasia is not known but it is believed to be related to the damage or degeneration of the nerves controlling the lower esophageal sphincter. The factors that may contribute to the development of achalasia include genetic factors, autoimmune disorders, and viral infections.
The symptoms of achalasia include:
- Difficulty in swallowing
- Intermittent chest pain
- Regurgitation of food from the esophagus
- Weight loss
- Coughing during the night
- Dry eyes and mouth
- Breathing undigested food into the lungs
There is no cure for achalasia but there are treatments that can be helpful in relieving the symptoms. The aim of the treatment is to alleviate symptoms, improve swallowing and prevent complications. The treatment options include:
- Medication including isosorbide or nifedipine
- Pneumatic balloon dilation involving enlarging the lower esophagus
- Surgery involving cutting of muscle fibers of the lower esophageal sphincter
Gastroesophageal Reflux Disease
Gastroesophageal reflux disease is a chronic digestive disorder. It occurs when stomach acid and other content from the stomach flow back into the esophagus and irritate the lining of the esophagus.
It occurs due to the malfunctioning of the lower esophageal sphincter, a ring of muscle that normally plays the role of preventing contents of the stomach from flowing back into the esophagus. A few factors that contribute to the development of gastroesophageal reflux disease include:
- Alcohol consumption
- Hiatal hernia
- Certain medication
The symptoms of gastroesophageal reflux disease include:(3)
- Chest pain
- Difficulty in swallowing
- Mouth, throat, and lung complications
Its treatment involves lifestyle modification such as avoiding trigger foods, losing weight, quitting smoking, and medication that promotes acidity. In severe cases, surgery may be recommended to strengthen or correct the hiatal hernia.
Untreated gastroesophageal reflux disease may lead to complications including esophagitis, strictures, and esophageal cancer.
Gastroparesis is also known as delayed gastric emptying. This makes the emptying of the stomach slow, despite no blockage.
There are many causes of gastroparesis including diabetes, surgery on the stomach and vagus nerve, certain medications, and neurological disorders. In most cases, the real cause is not detected.(4)
The symptoms of gastroparesis include:
- Feeling of fullness
- Weight loss
- Abdominal pain
Treatment of gastroparesis basically involves treating the underlying cause of the condition and may involve:
- Dietary and lifestyle changes
- Surgical interventions including enteral nutrition, parenteral nutrition, and gastric electrical stimulation
Irritable Bowel Syndrome
Irritable bowel syndrome is a commonly occurring gastrointestinal disorder that is known to affect the large intestine. It can occur due to a combination of factors including the gut microbiome, increased sensitivity to pain in the gut, and abnormality in the motility of the colon.
It is a chronic condition that may lead to a variety of symptoms including:
- Abdominal pain
The symptoms may also trigger due to stress, hormonal changes, and certain food changes.
Irritable bowel syndrome can be diagnosed by the patient’s medical history and symptoms. The treatment involves:
- Bringing in the changes in the diet and lifestyle
- Avoiding trigger foods
- Increasing fiber intake
- Managing stress
Certain medications such as antispasmodics, laxatives, and antidepressants may be helpful in managing symptoms.
Irritable bowel syndrome is a chronic condition that may require ongoing management as it may impact the quality of life of a person.
Treatment Options for Motility Disorders
Motility disorders affect the movement of food through the digestive tract. The treatment options include:
- Medication: There are several medications available to manage motility disorders. Prokinetic drugs stimulate the muscle in the digestive tract and improve movement. Antispasmodics are used to reduce abdominal pain and cramping. Antacids are used to alleviate the symptoms of acid rise and heartburn.
- Botulinum toxin injections: These may be used in certain motility disorders where the muscles of the digestive tract are affected. Botulinum toxin is a protein produced by the bacterium Clostridium botulinum and works by temporarily paralyzing muscles. Botulinum toxin may help reduce muscle spasms and improve motility.
- Endoscopy Therapy: Endoscopy involves a variety of techniques balloon dilation, stent placement, and endoscopic mucosal resection. Endoscopy can be an effective treatment but may not be appropriate for everyone.
- Surgery: In some motility disorders surgery may be needed for treatment. For example, in severe gastroparesis, the gastric electrical stimulator may be implanted to improve stomach motility.
The treatment of motility disorder may depend on the individual and the severity of the condition. It is important for people with motility disorder to seek help immediately and get an individual plan developed that would work the best.
Coping with Motility Disorders
Coping with motility disorders can be challenging. There are several factors that can be helpful.
- Dietary Changes: Modification of diet can help in improving the symptoms of motility disorders. If a person has constipation, increasing fiber intake can help in softening stool. Those with diarrhea can avoid trigger foods such as spicy foods, caffeine, and alcohol.
- Lifestyle Modifications: Lifestyle modifications including eating smaller frequent meals, staying hydrated, exercising regularly, and avoiding trigger foods can help in managing the symptoms and improving the quality of life. It is also important to get 7-8 hours of sleep every night to keep up the digestion.
- Support Groups: Joining support groups can be helpful as it provides emotional support and provide practical advice in managing symptoms.
- Mental Health Support: Living with a motility disorder can be challenging and stressful. It is therefore important to prioritize mental health and seek support when needed.
Motility disorders interfere with the transit of food and waste through the digestive tract. The food may be either too quick or too slow or backward causing problems with digestion and also excretion. The condition can be difficult to manage, but, there are several strategies that can help alleviate the symptoms.
It is important to seek help from a medical professional and develop a personalized plan that can help provide relief from the symptoms. Also, mental health should be prioritized and support should be taken when needed.
With the right treatment and support, the symptoms of motility disorder can be managed and this can improve the quality of life.