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    Gastrointestinal Motility

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    muh nuer
    This document discusses gastrointestinal motility, which refers to the muscular movement and transit of contents through the digestive system. It occurs through an organized sequence of contractions from the esophagus to the colon. When the nerves or muscles of the digestive tract do not function in a coordinated way, motility problems can develop and cause symptoms. The pathogenesis of gastrointestinal disorders involves bidirectional communication between the central and enteric nervous systems, known as the brain-gut axis, which links sensation in the gut to motor function and can be affected by stress, cognitive factors, and emotions. Common motility disorders include irritable bowel syndrome and dyspepsia.

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    Gastrointestinal Motility

    Uploaded by

    muh nuer
    100 views20 pages
    This document discusses gastrointestinal motility, which refers to the muscular movement and transit of contents through the digestive system. It occurs through an organized sequence of contractions from the esophagus to the colon. When the nerves or muscles of the digestive tract do not function in a coordinated way, motility problems can develop and cause symptoms. The pathogenesis of gastrointestinal disorders involves bidirectional communication between the central and enteric nervous systems, known as the brain-gut axis, which links sensation in the gut to motor function and can be affected by stress, cognitive factors, and emotions. Common motility disorders include irritable bowel syndrome and dyspepsia.

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    This document discusses gastrointestinal motility, which refers to the muscular movement and transit of contents through the digestive system. It occurs through an organized sequence of contractions from the esophagus to the colon. When the nerves or muscles of the digestive tract do not function in a coordinated way, motility problems can develop and cause symptoms. The pathogenesis of gastrointestinal disorders involves bidirectional communication between the central and enteric nervous systems, known as the brain-gut axis, which links sensation in the gut to motor function and can be affected by stress, cognitive factors, and emotions. Common motility disorders include irritable bowel syndrome and dyspepsia.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    100 views20 pages

    Gastrointestinal Motility

    Uploaded by

    muh nuer
    This document discusses gastrointestinal motility, which refers to the muscular movement and transit of contents through the digestive system. It occurs through an organized sequence of contractions from the esophagus to the colon. When the nerves or muscles of the digestive tract do not function in a coordinated way, motility problems can develop and cause symptoms. The pathogenesis of gastrointestinal disorders involves bidirectional communication between the central and enteric nervous systems, known as the brain-gut axis, which links sensation in the gut to motor function and can be affected by stress, cognitive factors, and emotions. Common motility disorders include irritable bowel syndrome and dyspepsia.

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    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 20

    GASTROINTESTINAL

    MOTILITY

    Rifai Amirudin

    GASTROINTESTINAL
    MOTILITY DEFINITION
    MOVEMENT OF THE DIGESTIVE
    SYSTEM, AND THE TRANSIT OF
    THE CONTENTS WITHIN IT
    MOTILITY IS THE MUSCULAR
    ACTIVITY OF THE
    GASTROINTESTINAL TRACT. IS AN
    ORDERLY SEQUENCE OF
    MUSCULAR CONTRACTION FROM

    GASTROINTESTINAL
    MOTILITY
    IF DIGESTIVE TRACT (NERVES OR
    MUSCLES) DONT FUNCTION IN
    COORDINATED
    FASHION,
    A
    PERSON DEVELOPS SYMPTOMS
    RELATED TO MOTILITY PROBLEM.

    GASTROINTESTINAL
    MOTILITY PATHOGENESIS
    AND PATHOPHYSIOLOGY
    THE EVOLVING THEORY SUGGESTS
    CHRONIC G.I SYMTOMS ARE
    GENERATED BY A COMBINATION OF :
    * INTESTINAL MOTOR
    * SENSORY
    * CNS ACTIVITY
    IT IS MEAN BI-DIRECTIONAL
    PATHWAYS BETWEEN
    -THE CENTRAL NERVOUS SYSTEMS
    -THE ENTERIC NERVOUS SYSTEMS
    SO CALLED BRAIN-GUT AXIS

    GASTROINTESTINAL MOTILITY
    PATHOGENESIS AND
    PATHOPHYSIOLOGY
    BI-DIRECTIONAL PATHWAYS PROVIDES THE
    LINKAGE BETWEEN :
    - SENSATION IN THE GUT
    - INTESTINAL MOTOR FUNCTION
    ENTERNAL STRESSORS
    COGNITIVE INFORMATION
    HAVE BY NATURE OF THEIR NEURAL
    CONNECTIONS IN THE BRAIN, THE
    CAPABILITY TO AFFECT G.I MOTILITY.
    THERE ARE THREE FEATURES TO G.I
    DISORDERS :

    Pathogenesis &
    Pathophysiology of Motility
    Behavioural factors
    External Stressors
    Cognitive Information
    Emotion
    Thought

    Increased
    visceral
    perception

    Altered
    motility

    Mechanisms Underlying
    Increased Sensory Perception
    Reduced
    descending
    inhibition

    Increased
    sensory
    input

    Upper G.I Motility


    Abnormal Fundic Relaxation in
    Response to Meal
    Normal

    Fundic
    accommodatio
    n or receptive
    relaxation

    Meal

    Abnormal
    Fundic

    Impaired fundic
    accommodation
    with a
    redistribution of
    food to antrum
    (Gilja O. Dig Dis Sci 1996;41:689)

    LOWER GASTROINTESTINAL
    MOTILITY
    PROPULSIVE MOTILITY IN THE SMALL
    INTESTINE IS ORGANIZED FROM A BASIC
    STEREOTYPED SEQUENCE OF
    CONTRACTION AND RELAXATION OF
    LONGITUDINAL AND CIRCULAR MUSCLES
    COATS

    Mechanisms Underlying Altered


    Motility
    Stress
    Behavioural
    Factors

    Local Factors:
    Gastritis
    H. pylori infection

    Abnormal Motility
    Decreased antral motility
    Impaired fundal relaxation

    Putative Pathogenesis of Abnormal


    Motility
    Stress
    ANS Imbalance

    Increased Sensitivity

    Sensory Inhibition
    .
    ..
    Sensitivity

    Increased
    Afferent
    Activity

    Impaired Motor Activity


    Accommodation

    Altered Motor & Sensory Function


    Abnormal Motility

    GASTROINTESTINAL
    MOTILITY THE SYMPTOMS
    ABDOMINAL DISTENTION
    NAUSEA AND OR
    VOMITING
    DIARRHEA
    OBSTIPATION
    HEARTBURN

    MOTILITY DISORDERS G.I


    DISORDERS
    MOST COMMONTLY MILLIONS OF
    PEOPLES
    PRESENTED G.I ILLNESSES SEEN BY
    PHYSICIANS
    I.B.S AND DYSPEPSIA ARE THE MOST
    COMMON
    IBS ALONE AFFECTS 10 20 % OF
    ADULTS
    APPROXIMATELY 25 MILLION

    MOTILITY DISORDERS
    GASTROINTESTINAL DISORDERS INCLUDE

    G.I DYSMOTILITY AND


    DYSPEPSIA
    DYSPEPSIA SUBGROUP

    PREDOMINANTSYMPTOMS

    DYSMOTILITY - LIKE

    UPPER ABDOMINAL DISCOMFORT;


    EARLY SATIETY,BLOATING,POSTPRANDIAL
    FULLNESS,NAUSEA,RETCHING/VOMITING

    ULCER - LIKE

    EPIGASTRIC PAIN,PAIN MAY BE RELATED


    TO MEALS,AND RELIEVED BY ANTACID OR
    ACID REDUCING DRUGS

    NON SPECIFIC

    NO PROMINENTSYMPTOM

    SYMPTOMATIC REFLUX

    HEARTBURN OR ACID REGURGITATION

    OVERLAP OF DYSPEPSIA
    SUBGROUPS

    ULCER-LIKE
    25 %

    DYSMOTILITY-LIKE
    9%
    1%
    3%

    4%

    5%
    REFLUX-LIKE
    10 %

    Major Causes of Dyspepsia

    % of Patients with
    Diagnosis

    Williams 1988
    (n=1386)

    Stanghellini 1996
    (n=1057)

    Heikkinen 1996
    (n=766)

    60
    50
    40
    30
    20
    10
    0

    Gastric Cancer

    Peptic Ulcer

    Esophagitis/
    GERD

    Functional
    Dyspepsia

    % of Patients with Functional


    Dyspepsia who also have IBS

    Functional Dyspepsia and Irritable


    Bowel Syndrome
    50

    44%

    45
    40
    35
    30

    29%

    25
    20
    15
    10
    5
    0

    Ulcer-like
    Dyspepsia

    Dysmotility-like
    Dyspepsia
    (Jones R. Gut 1990;31:401)

    Interview and Examination Symptoms and Signs

    Suggest
    GERD
    Disease
    Heartburn

    Suggest Ulcer-like Suggest Dysmotility-like


    Suggest
    Dyspepsia
    Dyspepsia
    Structural
    Burning pain

    Nausea

    Weight loss

    Regurgitation

    Relief of pain
    with food

    Bloating

    Dysphagia

    Reflux

    Localized epigastric
    Early satiety
    pain
    Pain worse
    Nocturnal/
    with food
    fasting pain

    Vomiting
    Bleeding

    Palpable mas

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