Motility is the contraction of the muscles which blend and push the contents in the gastrointestinal tract. The esophagus carries food to the stomach, the stomach mixes food with the digestive enzymes and breaks it down into a form that can be easily assimilated, the small intestine absorbs the nutrients, and the colon reabsorbs water and throws out the wastes.
The small intestine and the colon are called the bowel; and an anomaly in these organs affects the working of the gastrointestinal tract.
Common manifestations include:
- Constipation or diarrhea
- Nausea and vomiting
- Bloating of the abdomen
- Abdominal cramps and pain
What Causes Bowel Motility Problems?
- Abnormal motility patterns result from weak contractions or too strong contractions or from disorganized contractions which get triggered from intestinal muscle or nerve problems.
- Small bowel bacterial overgrowth causes abnormal motility in the small intestine.
- A reduction in the number of high amplitude contractions in the colon, i.e. the large bowel triggers a sluggish bowel movement and consequently constipation.
- Pelvic floor dyssynergia is another important cause. The external anal sphincter, a component of the pelvic floor remains closed to prevent any leakage. When you want to have a bowel movement, this sphincter opens to permit the fecal material to get expelled. Occasionally, people have difficulty relaxing this sphincter muscle or contrarily they may constrict it more tightly, so that it closes when straining at stool. This causes constipation.
- When one has too many high amplitude contractions, diarrhea sets in; and the amount of time food remains in the colon for water to be reabsorbed gets diminished.
- Fecal incontinence is the involuntary passage of feces in an individual over 4 years of age. The causes are – a defect in the anal sphincter muscles; loss of sensation for rectal fullness; chronic constipation, wherein the rectum overflows; stiff rectum, wherein the feces gets forced out very quickly that there is no time to prevent incontinence; and diarrhea can also lead to fecal incontinence.
- Hirschsprung’s disease is another significant cause. We have two anal sphincter muscles – internal that is part of the intestines, and an external that is part of the pelvic floor muscles. The internal anal sphincter remains closed in order to check leakage of liquid / gas from the rectum, however, when the rectum gets full of feces, a reflex makes it open up to permit evacuation. Sometimes, the nerves which control this reflex may be absent at birth, consequently, the internal anal sphincter will stay firmly shut and bowel movements fail to occur. This defect is known as Hirschsprung’s disease.
Treatment For Bowel Motility Disorders
- Confer with your health care provider to understand the precise cause of the symptoms. He will ask you to perform a few tests and investigations to make an accurate diagnosis. Your doctor will prescribe medications to deal with the nausea and vomiting, heartburn and diarrhea / constipation.
- He will also prescribe for you a motility diet, which helps normalize bowel motility.
- You should eat 4 to 6 meals through the day. The portion size of each meal must be small. You also need to reduce the intake of fat and fiber.
- Include a lot of well-cooked vegetables and fruits; juice and milk; and cooked meat, seafood and poultry which has been pureed.
- Reduce your intake of whole grains, legumes and high-fiber foods, like sprouts, apples, oranges, green beans, peas and leafy greens.
- If you have a chronic problem, do not attempt to design a motility diet on your own. Get advice from your nutritionist to make sure that you’re getting adequate amounts of the nutrients that the body requires. It may also be necessary to take dietary supplements in case you fail to meet your nutritional requirements with diet alone.