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Disorders of gastrointestinal hypomotility.

Bielefeldt, Klaus and Tuteja, Ashok and Nusrat, Salman (2016) Disorders of gastrointestinal hypomotility. F1000Res, 5. ISSN 2046-1402

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Abstract

Ingestion and digestion of food as well as expulsion of residual material from our gastrointestinal tract requires normal propulsive, i.e. motor, function. Hypomotility refers to inherited or acquired changes that come with decreased contractile forces or slower transit. It not only often causes symptoms but also may compromise nutritional status or lead to other complications. While severe forms, such as pseudo-obstruction or ileus, may have a tremendous functional impact, the less severe forms of hypomotility may well be more relevant, as they contribute to common disorders, such as functional dyspepsia, gastroparesis, chronic constipation, and irritable bowel syndrome (IBS). Clinical testing can identify changes in contractile activity, defined by lower amplitudes or abnormal patterns, and the related effects on transit. However, such biomarkers show a limited correlation with overall symptom severity as experienced by patients. Similarly, targeting hypomotility with pharmacological interventions often alters gut motor function but does not consistently improve symptoms. Novel diagnostic approaches may change this apparent paradox and enable us to obtain more comprehensive information by integrating data on electrical activity, mechanical forces, patterns, wall stiffness, and motions with information of the flow of luminal contents. New drugs with more selective effects or more specific delivery may improve benefits and limit adverse effects. Lastly, the complex regulation of gastrointestinal motility involves the brain-gut axis as a reciprocal pathway for afferent and efferent signaling. Considering the role of visceral input in emotion and the effects of emotion on visceral activity, understanding and managing hypomotility disorders requires an integrative approach based on the mind-body continuum or biopsychosocial model of diseases.

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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Bielefeldt, Klaus
Tuteja, Ashok
Nusrat, Salman
Contributors:
ContributionContributors NameEmailPitt UsernameORCID
ReviewerBercik, PremyslUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
ReviewerBeyder, ArthurUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Date: 28 July 2016
Date Type: Acceptance
Journal or Publication Title: F1000Res
Volume: 5
DOI or Unique Handle: 10.12688/f1000research.8658.1
Schools and Programs: School of Medicine > Medicine
Refereed: Yes
Uncontrolled Keywords: Gastrointestinal hypomotility, brain-gut axis, diagnostics, gut motor function, hypomotility disorders, visceral activity
ISSN: 2046-1402
Date Deposited: 29 Nov 2016 20:48
Last Modified: 20 Dec 2018 00:55
URI: http://d-scholarship.pitt.edu/id/eprint/30104

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