Gastrointestinal Motility

There are many GI motility disorders that can have an affect on the esophagus or the colon (large intestine) or the rectum. Each part of the digestive system (GI tract) has a special function to perform in the process of digestion. Each function has a type of motility and sensation that is associated with its function. When either the motility or the sensation is not appropriate, the function can be affected and symptoms occur.

Gastrointestinal motility is the movements that are made within the digestive system, as the contents of digestion are processed from one organ to the other along the digestive tract. Symptoms of a disorder may be discovered as motility problems present themselves in the course of function and normal strength becomes out of alignment with what is normal.

In the esophagus motility disorders may be seen as gastroesophageal reflux disease (GERD), achalasia, functional chest pain, or dysphagia. In the stomach, motility disorders may manifest as delayed gastric emptying (gastroparesis), rapid gastric emptying (dumping syndrome), functional dyspepsia, or as cyclic vomiting syndrome (CVS).

In the small intestine motility disorders may occur in the form of intestinal dysmotility, intestinal pseudo-obstruction, or as small bowel bacterial overgrowth. In the large intestine also known as the colon, motility disorders may be seen as constipation, diarrhea, hirschsprung’s disease, or as irritable bowel syndrome (IBS).

Other GI motility disorders are fecal incontinence, and also outlet obstruction type constipation (pelvic floor dyssynergia).

Symptoms may not be enough to help diagnose the problem so a proper evaluation of the individual must be done. Different GI motility tests are performed for each of the areas of the GI tract.

The information gathered from these tests can help doctors by providing a correct diagnosis, can be a guide for treatment, and can help with the prognostic information to be given to the individual.

The tests can define the anatomy of the digestive tract, and may reveal any structural problems that may exist before proceeding to a second set of tests that will evaluate the individual functions of the organs of the digestive system.

Motility is vital to the function of the digestive system because without the movement of food contents from one part of the digestive system to another proper nutrition absorption cannot take place. If nutritional absorption does not take place, then the cells of the body would not have what they need for proper growth and for energy.

Diagnosis and Tests

When symptoms are presented the doctor will be looking to distinguish GI motility disorders from the possible locations including the disorders of the esophagus, stomach, small intestine, and also disorders of the pelvic floor.

Motility testing on the esophagus includes: esophagram, upper endoscopy, esophageal manometry, an ambulatory 24-hour pH probe and also an impedance test.

Motility testing on the stomach includes: gastric emptying, gastroparesis and functional dyspepsia.

Motility testing on the small intestine includes: small bowel manometry, upper endoscopy and also a hydrogen breath test to check for bacterial overgrowth.

Motility testing on the large intestine includes: barium enema, sigmoidoscopy or a colonoscopy, colonic transit time study, and also a scintigraphic emptying and transit study.

If diarrhea is a symptom the doctor may ask you to provide a sample of your stool, and to keep a diary of the number of bowel movements and the rate of consistency (whether they are watery, loose, formed etc.). This diary may also include what foods you are eating. You will most likely be asked to keep this diary for one or two weeks.