The Kyle MacFarlane Foundation

Funding research and awareness in the field of neurogastroenterology and motility

What Are Gastrointestinal Dysmotilities?

Understanding GI Dysmotilities

By Dr. Linda Ann Nguyen, Clinical Assistant Professor, Director GI Motility and Neurogastroenterology at Stanford University

What are Gastrointestinal Dysmotilities?
Gastrointestinal dysmotilities (GI dysmotilities) are a group of disorders that affect the normal functioning of the GI tract spanning the esophagus to the anorectum. Examples of normal function are digestion of food/nutrients and defecation. Dysmotilities can affect a specific part of the GI tract, or the entire system. Typically, there is no visible evidence of the disease.

GI dysmotilities affect up to 25 percent of the US population, impacting health care burden and patient quality of life. In comparison, high blood pressure affects 28 percent of the population, and asthma affects eight percent of the population.

Symptons
The symptoms of GI dysmotilities can sometimes be vague, leading to difficulties in diagnosis. These symptoms include abdominal pain, nausea, vomiting, diarrhea, constipation, anal/rectal pain, bloating, heartburn, chest pain, difficulty swallowing, or loss of appetite. These symptoms can significantly worsen the quality of life for patients. A good appetite and digestion are so much part of our normal well being that we take it for granted. In some patients, these illnesses can become life threatening when they prevent adequate nutrition, resulting in weakness and weight loss.

Examples of Localized Dysmotilities
Examples of localized dysmotilities include gastroesophageal reflux (GERD), achalasia, diffuse esophageal spasm (DES), gastroparesis, nonulcerative dyspepsia (NUD), chronic intestinal pseudoobstruction, irritable bowel syndrome (IBS), idiopathic constipation, fecal incontinence, and pelvic floor dysfunction. These entities can overlap (i.e. patients with IBS can also suffer from GERD). There are also non-specific GI dysmotilities where physiologic testing reveals an abnormality but these abnormalities do not fit a specific diagnosis.

Why the diseases are difficult to diagnose
Unfortunately, GI motility disorders are frequently under recognized due to a variety of factors, including lack of understanding of the disease mechanism, lack of reliable or readily available objective tests/disease markers, and lack of safe and effective medical therapy. Patients are too frequently dismissed as they “look” ok, and all of their tests are normal. Yet, they still suffer.

Why more research about these diseases is needed
Further understanding of the disease mechanism is key to impacting patient care and quality of life. This can lead to improved awareness, improved diagnostic testing, and better therapies.  Progress in clinical and basic science research has been made over the years to help in the understanding of the enteric nervous system and its impact on GI dysmotilities. However, we are far from filling the gap that will lead to improving our patients’ lives. Science and medicine has helped us to extend life expectancy. But what is the benefit of living longer, if one is suffering during those additional years?

 

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