Dysmotility

Dysmotility is a digestive system disorder characterized by poor strength or coordination of the muscles of the digestive system. This disorder most commonly affects the small intestine. This muscular or neurological impairment, in turn, affects the contraction of intestinal muscles that aid the movement of food through the digestive tract. Food may be poorly absorbed, may move too quickly or slowly during the digestive process, or may become trapped in the digestive tract. This can lead to a host of uncomfortable symptoms. While dysmotility often cannot be cured, there are several steps that patients can take to treat or avoid symptoms.

Definition & Facts

When the digestive tract is functioning normally, muscle contractions allow food to move through at a steady pace. In this way, the body is able to absorb nutrients and eliminate waste properly. The poor muscle strength or coordination in cases of dysmotility interrupts this process.

Dysmotility is usually caused by either digestive muscle or neurological impairment; that is, there is an underlying disease process or disorder, and dysmotility is a secondary condition. Less commonly, dysmotility occurs on its own with no underlying condition.

Dysmotility may have a hereditary link as those with the disorder are often found to have a family history of muscular or neurological disorders. Motility issues can occur anywhere along the digestive tract from the esophagus to the colon. Dysmotility and gastroparesis, which affects the stomach can occur in patients of any age but is most likely to occur in young children and the elderly.

Symptoms & Complaints

Some people with dysmotility are asymptomatic. That is, they experience few or no symptoms. Others experience a range of complaints from mild to severe. These symptoms include: 

• Gas, bloating, and abdominal distension
• Abdominal cramping and abdominal pain- this can vary from mild to intense
• Diarrhea or constipation
• Loss of appetite, nausea, and vomiting
• Malnutrition

Patients with severe dysmotility may have difficulty eating due to their symptoms. These patients may also experience symptoms of weakness and fatigue caused by dehydration, vomiting, diarrhea, and malnutrition. Most symptoms of dysmotility occur after eating. 

Causes

Occasionally, dysmotility can occur on its own. More often, however, an underlying disease process or inherited motility issue is the cause. Parkinson’s disease, muscular dystrophy, thyroid disorder, and other neurological disorders have all been associated with dysmotility. In addition, 1:4 diabetics will develop dysmotility or a related digestive disorder.

The condition has also been associated with cancer treatments or certain medications, viral infections and bacterial infections of the digestive tract, current or prior history of eating disorders - such as bulimia or anorexia - and prior abdominal surgeries.

Doctors note that in cases of dysmotility patients often report unhealthy dietary behaviors that include late night eating, overconsumption of rich or high-fat foods, and excessive alcohol consumption. Each of these behaviors affects the body’s ability to break down food and may contribute to the development of dysmotility. 

Diagnosis & Tests

Symptoms of dysmotility are very similar to those of intestinal blockage, so the disorder cannot be diagnosed through symptoms alone. Several tests are available to help doctors determine whether patient symptoms are caused by intestinal blockage or dysmotility.

Initially, a doctor may order a barium X-ray in order to look for blockages in the intestine. If no blockages are found, the X-ray can also allow doctors to study the movement of material through the intestinal tract. If abnormal movement – that is movement that is too fast, too slow, impaired or uncoordinated - is detected, dysmotility can be diagnosed.

A doctor may also order blood tests. These tests can help diagnose underlying disorders that may be the cause for dysmotility such as diabetes or lupus. It can also help doctors diagnose conditions likely to result from dysmotility. These include anemia, blood salt imbalances, and malnutrition. Finally, a doctor may order an endoscopic biopsy. This may also help determine the exact cause of a patient’s dysmotility. 

Treatment & Therapy

Dysmotility is often not curable, so treatment focuses on relieving symptoms and ensuring that the patient is able to get adequate nutrition. Prior to treatment for dysmotility a patient should discuss any current medications with a doctor to ensure that these medications are not contributing to motility issues. In addition, any functional blockages must be removed before treatment can begin.

The most common treatment for dysmotility is a dietary change. Patients are advised to avoid difficult to digest foods which include – but are not limited to - whole grain and high fiber foods, beans, nuts and seeds. Patients should also avoid gas-producing foods as they can exacerbate symptoms. Dietary supplements may also be recommended to ensure proper nutrition.

Antibiotics may be prescribed if motility issues have caused or are exacerbated by bacterial infections. Surgery is a last resort for patients who have not responded well to other treatments and are profoundly affected by their symptoms. 

Prevention & Prophylaxis

In addition, controllable behaviors are believed to play a role. A healthy diet and regular eating pattern can help avoid symptoms common to dysmotility. Carefully controlling disease processes such as diabetes may also reduce the risk of developing dysmotility. Other measures such as dietary changes, drug therapy, and learning cognitive and physical coping mechanisms focus on symptom prevention when prevention of the disorder itself is not a possibility.