Types of Dysmotility and Motility Disorders

A motility disorder, or dysmotility, is a condition in which muscles and/or nerves of the digestive system do not work as they should. This dysfunction can alter the speed, strength, or coordination of the esophagus, stomach, small intestine, and/or the large intestine.

If the muscles aren't working properly, it's known as myopathy. When the nerves affecting the digestive tract are involved, the conditions are related to neuropathy.

This article presents several types of motility disorders and their symptoms. It also explains the causes and treatments.

Types of Dysmotility

Motility disorders vary in terms of how serious they are, and the parts of the digestive tract that are affected. Some disorders tend to affect certain areas of the digestive system.

Esophageal Dysmotility

The esophagus is commonly affected by motility disorders. The most common is achalasia, caused by nerve cells that degenerate with a loss of control over muscle function. This keeps the lower esophageal sphincter (LES) from closing properly.

Other types of esophageal dysmotility include esophagogastric junction outflow obstruction, and both major and minor disorders of peristalsis. These major disorders include:

• Distal (diffuse) esophageal spasm
• Hypercontractile esophagus
• Absent contractility

The minor disorders of peristalsis in the esophagus include:

• Ineffective esophageal motility
• Fragmented peristalsis

Dysmotility of the Stomach

A number of motility disorders affect the stomach. They include cyclic vomiting syndrome, which typically affects children. It's thought to be related to how neurons in the brain send messages to the gastrointestinal tract. Other dysmotility conditions affecting the stomach include:

• Dumping syndrome (rapid gastric emptying)
• Gastroparesis (delayed gastric emptying)
• Functional dyspepsia

Motility Disorder of the Intestines

These conditions affect either the small intestine or the large intestine. Dysmotility in the small intestine includes:

• Intestinal pseudo-obstruction
• Small intestinal bacterial overgrowth

Health conditions involving dysmotility in the large intestine include:

• Dyssynergic defecation
• Fecal incontinence
• Functional constipation (chronic idiopathic constipation)
• Functional diarrhea
• Irritable bowel syndrome (IBS)

Symptoms of Dysmotility

Symptoms of a motility dysfunction will vary depending on which areas of your digestive system are affected and which type of motility problem you are having. For example, dysphagia (trouble swallowing) is a major symptom of dysmotility with the upper digestive tract.

Other symptoms of a motility disorder in this part of the GI tract include:

• Abdominal pain
• Burning or discomfort
• Vomiting

When the lower GI tract is involved, symptoms are more likely to result in lower abdominal pain, cramping, and diarrhea or constipation.

The speed of GI function is a factor of dysmotility disorders. Rapid dysfunction usually causes diarrhea because the contents of the digestive system are propelled too quickly, resulting in loose, watery stool.

Constipation occurs due to motility disorders that slow transit time and the movement of fluids, leading to hard stools that are difficult to pass.

Causes

Normally, the muscle contractions of your digestive system operate in a coordinated, orderly manner to facilitate the digestion of the foods that you eat. Dysmotility can result in slow and/or fast movement of food and chyme, the partially digested food and stomach acids in your GI tract.

Any change from normal motility can result in digestive symptoms.

Motility disorders can occur as a result of dysfunction in the nerves and muscles in any region of your digestive system. The cause is often unknown, but a number of underlying health diagnoses can cause dysmotility.

For example, about 9% of people treated for symptoms of dysphagia, chest pain, and reflux are living with a rheumatological condition such as lupus.

A number of medications can affect the nerve and muscle function in the GI tract, too. These drugs are used to treat high blood pressure, seizures, cholesterol levels, depression, and more.

Treatment for Motility Disorder

Treatment for a motility disorder will depend on several factors, including the type of dysmotility, a person's overall health, and any other underlying or related medical conditions.

A gastroenterologist or motility disorder specialist will first diagnose the disorder. In addition to a physical exam, tests used to diagnose a dysmotility condition may include:

• Blood tests
• Barium X-ray imaging
• Colonic transit time tests

In most cases, treatment will involve diet and lifestyle changes, medication, surgery, or a combination of these therapies.

For example, achalasia can be treated with calcium channel blocker drugs that limit blood flow to the esophageal sphincter, while Botox injections can help relax the esophagus to ease dysphagia. It also may be treated with a minimally invasive surgery called peroral endoscopic myotomy (POEM).

Motility disorder diets with added soluble fiber can help with conditions such as dyssynergic defecation and IBS with constipation. Your healthcare provider will develop a treatment plan that's specific to your condition.