Motility disorders are conditions that affect the movement of food and waste through the digestive tract. There are many types of motility disorder and they can impact any part of the digestive tract, from the esophagus to the rectum.
In a healthy digestive tract, muscles and valves move food from one part of the digestive system to another. Muscles push food along in a process known as peristalsis, and valves stop food from flowing backward.
When a person has a motility disorder, these processes do not work as they should. This may cause difficulty swallowing, digesting food, or having bowel movements, depending on the condition.
Read on to learn more about different motility disorders, including their symptoms, causes, and treatment.
A motility disorder is a condition that causes food and waste to move through the digestive tract in an atypical way. It may move slower or faster than it should or allow food to move backward when it should not.
This happens when the processes that move food along the digestive tract stop working as usual. The body moves food through the digestive tract in
During peristalsis, the longitudinal muscles that run down the outside of the digestive tract contract and relax. This propels food forward. Segmentation divides and mixes the contents of the digestive tract.
Many things can disrupt these processes, including structural differences in anatomy, nerve damage, and more.
Doctors broadly divide the digestive tract into upper and lower sections. The upper digestive tract includes the esophagus and stomach, while the lower part includes the intestines.
Motility disorders of the upper digestive tract include:
Motility disorders affecting the lower digestive tract include:
- intestinal pseudo-obstruction
- small intestinal bacterial overgrowth (SIBO)
- pelvic dyssynergia
- Hirschsprung’s disease
Achalasia is a rare disorder of the esophagus that causes problems with pushing food down toward the stomach and relaxing the lower esophageal sphincter, which is the ring-shaped muscle at the bottom of the esophagus.
The symptoms include:
- difficulty swallowing
- intermittent chest pain
- regurgitation of food from the esophagus
- breathing undigested food into the lungs, potentially causing pneumonia
- coughing during the night
- weight loss
- dry eyes and mouth
Researchers do not know exactly what causes achalasia, but they think it may relate to the degeneration of a group of nerves known as Auerbach’s plexus. Some people may also have a rare, inherited form of the condition.
- medications, such as isosorbide or nifedipine
- pneumatic balloon dilation, which enlarges the lower esophageal sphincter
- surgery to cut the muscle fibers of the lower esophageal sphincter
- chest pain
- painful swallowing
- complications in the mouth, throat, or lungs, such as chronic cough or hoarseness
Many people experience heartburn occasionally. Usually, the esophageal sphincter opens and closes to prevent it. In GERD, the esophageal sphincter consistently fails to stop food from coming back up the esophagus. Several things can contribute to this, including:
- smoking or inhaling secondhand smoke
- hiatal hernia
- certain medications, such as benzodiazepines, calcium channel blockers, certain asthma medicines, nonsteroidal anti-inflammatory drugs, and tricyclic antidepressants
Treatment for GERD can include lifestyle changes to decrease pressure on the esophagus or medications to reduce symptoms. However, these medications may have
In some cases, a doctor may recommend surgery.
Doctors sometimes call gastroparesis “delayed gastric emptying.” It causes a person’s stomach to empty too slowly, despite there being no blockage.
- feeling full soon after beginning to eat
- abdominal pain
- weight loss
Many things can cause gastroparesis. For example, surgery or diabetes may damage nerves in the stomach. In 30–50% of cases, doctors cannot identify a cause.
Treatments focus on managing symptoms. They may include:
- dietary and lifestyle changes
- surgical interventions, such as:
- enteral nutrition, which involves delivering nutrients directly to the stomach or small intestine
- parenteral nutrition, which involves feeding through a vein using a special nutrient formula
- gastric electrical stimulation, which stimulates movement of the stomach
Dumping syndrome happens when food moves too quickly from the stomach to the duodenum, which connects to the small intestine. There are two types: early and late dumping syndrome.
Early dumping syndrome causes symptoms within
- bloating or feeling uncomfortably full
- abdominal pain and cramping
- stomach rumbling
Late dumping syndrome causes symptoms 1–3 hours after eating and affects blood sugar levels. Symptoms include:
- feeling dizzy, shaky, or faint
- a fast or irregular heartbeat
- trouble concentrating
People with early dumping syndrome can also have these symptoms.
Hormonal imbalances or surgery may cause dumping syndrome. Treatments for the condition include:
- dietary changes
- medicines, such as octreotide (Sandostatin) or acarbose (Prandase or Precose)
- corrective surgery, if previous surgery is the underlying cause
Intestinal pseudo-obstruction is a
- abdominal pain
- bloating and feeling excessively full after meals
- nausea and vomiting
The condition occurs when nerve or muscle problems slow or stop the movement of food, fluid, air, and waste. Treatment for intestinal pseudo-obstruction
- dietary changes, such as avoiding fat or uncooked fiber
- medicines that help food move through the digestive tract more quickly
- decompression, which removes gas and fluids from the digestive tract using a tube that goes through the nose and into the stomach
- surgery, such as removing the affected part of the intestine, or an intestinal transplant
SIBO occurs when the microbes that usually live in the large intestine begin growing in large numbers in the small intestine. These microbes then ferment food as it passes through the gut, producing gases that the small intestine cannot easily expel. This can lead to:
Scientists are still learning about what causes SIBO, but motility problems may be a risk factor. If peristalsis does not work as it should, it may allow bacteria to start growing too much in the small intestine.
However, SIBO itself can also cause problems with motility. For example, people who mainly experience constipation often have overgrowths of microorganisms known as archaea, which produce methane. Methane has links to chronic constipation.
Treatment for SIBO involves removing the overgrowth of bacteria and addressing the underlying cause. For example, if low motility is causing SIBO, a doctor may prescribe a prokinetic to speed up peristalsis.
Pelvic dyssynergia develops when the muscles of the pelvic floor cannot relax or contract when they should not. This can cause:
- straining during bowel movements
- incomplete bowel movements
Training the pelvic floor muscles using techniques such as biofeedback can help treat pelvic dyssynergia. Biofeedback involves using a computer and special sensors to monitor a person’s bodily functions. With practice, a person can learn to consciously control these functions.
Other treatments may include:
- pelvic floor exercises
- Botox injections
- dietary changes that make bowel movements easier
- surgery, if a structural problem is causing the condition
Usually, the anal sphincter stops gas or liquid leaking from the rectum. When the rectum fills up, the sphincter opens to allow a bowel movement.
People with Hirschsprung’s disease are born without the nerves that control this reflex, meaning their body cannot open the sphincter for bowel movements. It is a rare condition a person can inherit from a parent.
Sometimes, the symptoms are present from birth, but they can also appear later on. They include:
- inability to pass a bowel movement within the first 24–48 hours of life
- vomiting and abdominal swelling in newborns
- chronic constipation
- small watery stools, diarrhea, and lack of appetite in older children
Doctors treat Hirschprung’s disease with surgery.
Doctors may diagnose motility disorders using a combination of a person’s symptoms, a physical examination, and the results from diagnostic tests. Depending on what they think may be the cause of a person’s symptoms, these tests include:
- an endoscopy or colonoscopy to see inside the body
- motility testing to see how quickly things move through the digestive tract
- hydrogen breath testing for SIBO
- ambulatory pH monitoring, which tests for acid reflux
- biofeedback to test for atypical bodily functions or reflexes
Motility disorders are conditions that interfere with the transit of food and waste through the digestive tract. Food may move too quickly, too slowly, or backward, causing problems with digestion and excretion.
Many motility disorders, and digestive conditions more generally, have similar symptoms. If a person is concerned they might have a motility disorder, they should consult a doctor or gastroenterologist so they can identify the problem and recommend treatments.