Motility disorder is a disorder of the digestive organs. Their physiological movement processes do not occur as in healthy individuals, which is why digestion is disturbed. The term motility disorders is used to describe many different disorders of the digestive processes.
What is a motility disorder?
To understand motility disorders, knowledge of the structure of the digestive tract is essential. The digestive tract has a special type of musculature along its entire length. This musculature is smooth and is located in the wall of the tract. Because motility disorders are fundamentally related to this smooth type of musculature, almost all sections of the digestive tract can be affected by motility disorders. These include, for example, the stomach, esophagus, duodenum, small intestine, colon, as well as the rectum. From a clinical perspective, the stomach, esophagus, colon, and rectum are most commonly affected by motility disorders. Since motility disorders are very versatile, different ways of categorizing the disorders exist. For example, it is possible to classify the disorders according to the type of disorder. This classification is based on the fact that motility disorders can result from both reduced and increased motility. Accordingly, a distinction is made between hypomotility, which results from reduced movement of the musculature, and hypermotility, which results from increased movement activity. In addition, motility disorders can be subdivided according to the cause of the disorder. The so-called primary motility disorders are an independent disease phenomenon. In contrast, secondary motility disorders represent sequelae resulting from other underlying diseases.
Causes
The exact cause of each motility disorder differs from case to case and also depends on which section of the digestive tract is affected by a disorder. In principle, all motility disorders and their associated symptoms and complaints are triggered by abnormal contractions of the muscles. These muscles are located along the digestive tract beginning at the esophagus and extending to the rectum. In principle, motility disorders are relatively widespread in the population. However, in the majority of cases they are comparatively harmless and usually do not pose a serious threat to the life of the affected patient. Nevertheless, they are perceived as disturbing by numerous ill persons and sometimes impair the individual quality of life. On the other hand, there are also forms of motility disorders which, due to their manifestation and severity, urgently require medical therapy. This is because if the symptoms of motility disorder are not treated, in the worst case the death of the affected patient is imminent, as in some cases life-threatening complications arise.
Symptoms, complaints, and signs
Basically, the term ‘gastrointestinal motility disorders’ encompasses specific forms of movement disorders of the digestive tract that result in a number of different symptoms and complaints. These symptoms vary depending on the patient and the severity of the disorders. Motility disorders occur either singly or in multiple sections of the gastrointestinal tract. For example, they affect the esophagus, the large or small intestine, and the stomach. In some cases, motility disorders cause only mild symptoms; in other cases, they lead to long-lasting and threatening symptoms. The motility disorders are based either on a reduced movement of the muscles, in which the muscles are partially as if paralyzed. On the other hand, there is the possibility that the musculature of the digestive tract works too hard and often moves in an uncoordinated manner in connection with this. The respective symptoms depend strongly on the affected section of the gastrointestinal tract. Possible clinical pictures include achalasia, gastroparesis, functional dyspepsia (or so-called irritable stomach), irritable bowel syndrome, and chronic intestinal pseudoobstruction.
Diagnosis and course of disease
With regard to the diagnosis of motility disorders, various possibilities and examination methods exist. Basically, in the vast majority of cases, it is relatively laborious to diagnose motility disorders with certainty.This is because a pictorial representation of the digestive tract alone is not sufficient, as the primary objective is the functional examination of movements of the intestines or other areas of the digestive tract. In many cases, so-called manometry is used. However, this is only suitable for certain sections of the digestive tract. Esophageal manometry examines the esophagus, while antroduodenal manometry analyzes the gastric outlet and duodenum. There is also the option of small bowel, colon and rectum manometry. In some cases, a barostat examination is also performed, which allows insights regarding the relationship of pressure and volume. For this purpose, an intraluminal balloon is inserted into the rectum. As the balloon slowly unfolds, the cognition and defecation reflex of the affected patient can be studied. Fluoroscopy involves dynamic X-ray imaging using special contrast agents. The movement behavior of individual areas of the gastrointestinal tract is examined.
Complications
As a rule, motility disorders cause various discomforts and disorders in the stomach and intestines. As a result, various complications and discomforts may occur, depending greatly on the severity of the motility disorder. As a rule, however, the daily life of the affected person is significantly restricted. It is not uncommon for the motility disorder to lead to a so-called irritable bowel or irritable stomach, so that the affected person has to struggle with abdominal pain or constipation even with light food. Due to the permanent stomach complaints, it is not uncommon for psychological complaints or even depression to occur. An early diagnosis is not possible in many cases, because the complaints are not characteristic for the disease and can therefore also be confused with other diseases. The treatment of this disease is usually done by various medications and therapies. As a rule, there are no particular complications and the life expectancy of the patient is not limited by this disease. However, in many cases the affected person is also dependent on a healthy lifestyle to limit the symptoms of the motility disorder. In most cases, however, this results in a positive course of the disease.
When should you see a doctor?
Digestive tract disorders should be sought medical attention if they persist over a long period of time. In the case of one-time impairments, there may be short-term disturbances of digestion that subside due to the self-healing mechanism of the organism. In the case of persistent disturbances, clarification of the cause is necessary so that treatment can take place and thus relief from the symptoms can be achieved. If the irregularities occur immediately after food intake, intolerances to ingested food may be the reason. Persistent emotional or mental stress as well as stressful life circumstances are also possible causes of the motility disorder. In a discussion with the doctor, possible influencing factors are discussed and narrowed down. If the affected person suffers from an irritable stomach, a noise in the area of the stomach or intestines as well as diffuse pain, a doctor is needed. If flatulence, diarrhea or constipation occur over several days or weeks, they should be examined and treated. Loss of appetite, sluggishness, increased fatigue and exhaustion indicate health disorders that should be evaluated by a physician. Worrying signs include paralysis of the muscles, restricted movement and a loss of the usual ability to perform and concentrate. If the daily requirements can no longer be met as usual, the affected person needs help. If circulatory disturbances, a general feeling of illness, and sleep disturbances occur, a physician should be consulted.
Treatment and therapy
The treatment of motility disorders depends primarily on the individual manifestation of the disorder. On the one hand, there is the possibility of dietary measures that may have a positive influence on the digestive tract. Various medications are also available, for example prokinetics. In severe cases, invasive therapeutic procedures are necessary.
Outlook and prognosis
The outlook depends on the extent and cause of the disease.In most cases, a motility disorder can be remedied by simple means. In most cases, adherence to a diet is enough to stop the symptoms. In other cases, taking medication leads to a cure. Drugs themselves can sometimes also trigger a motility disorder. In such cases, a substitute for the active ingredients must be found. As a rule, the above-mentioned measures promise recovery. To some extent, they can also be carried out by the patient himself. This results in a good prognosis, which can be achieved by simple means. Only rarely does a motility disorder lead to a reduction in the quality of life. This is the case when the described measures do not lead to success. Invasive interventions then become necessary. If patients forego therapy in such a severe course, gastric paralysis or intestinal obstruction are the result. This results in a high risk that has an impact on the patient’s lifespan. Certain diseases such as food allergies, diabetes, a nervous system condition and hypothyroidism favor a severe course. The outlook then worsens accordingly.
Prevention
Potential measures to prevent motility disorders are many and varied. Basically, a healthy lifestyle with a balanced diet and exercise contributes to normal digestive tract function.
Follow-up
In most cases, there are no special or direct measures of aftercare available to the affected person in the case of motility disorder, so that the affected person should first and foremost see a doctor very quickly and, above all, at an early stage. As a rule, the condition cannot be cured on its own, so that a quick diagnosis and subsequent treatment by a doctor is always necessary. As a rule, the motility disorder can be treated relatively well by a strict diet. In this case, the doctor can also provide the affected person with a diet plan. In general, this disease requires attention to a healthy lifestyle with a balanced diet, avoiding alcohol and tobacco. Likewise, taking various medications can also alleviate and limit the symptoms of motility disorder. The affected person should pay attention to a correct dosage and a regular intake of the medication. Regular checks by a doctor are also very important. In most cases, this disease does not reduce the life expectancy of the affected person, although the further course is very much dependent on the time of diagnosis, so that a general prediction is usually not possible.
What you can do yourself
The actions that sufferers of motility disorder can take depend primarily on the nature and severity of the disorder. In general, gastrointestinal health can be improved by changing the diet. Patients should avoid irritating foods as well as stimulants and instead include more digestive foods and beverages in their diet. In combination with a well-controlled medication, the symptoms can be effectively alleviated. In severe cases, however, surgery is required. Since surgery on the gastrointestinal tract poses a great risk to the patient, close monitoring by the physician is necessary. Accompanying this, attention should be paid to any accompanying symptoms or unusual complaints. For example, if bleeding or severe pain occurs after surgery, the responsible physician must be informed. Basically, after a surgical procedure, rest is important. Especially in the first days and weeks after the operation, the body and in particular the gastrointestinal tract must not be subjected to too much stress. The doctor’s instructions regarding diet, hygiene measures and rest must be observed in any case. Otherwise, serious complications may arise that delay the healing process.
