Understanding and Treating Gut Dysmotility: Causes, Symptoms, and Remedies

What Is Gut Dysmotility?

Normally, the food you ingest is pushed forward through the gut by wave-like muscle contractions called peristalsis. Gut dysmotility is a condition that occurs due to problems with the contraction of muscles that make up your gastrointestinal tract. Impairment of these muscles causes changes in the speed or strength of contractions.

Gut dysmotility can affect any part of your digestive tract, including the oesophagus (food pipe), stomach, small intestine, or large intestine.

It is estimated that 10% to 30% of people in Western countries suffer from some form of intestinal dysmotility.

There are several types of motility disorders that affect the different parts of the gut. Some of the common forms of dysmotility include:

1. Gastroparesis:

This condition slows or stops the movement of food from your stomach to the small intestine and is also known as delayed gastric emptying.

2. Chronic Intestinal Pseudo-Obstruction (CIPO):

This condition causes the symptoms of an intestinal obstruction without a mechanical blockage, leading to abdominal pain, distension, and constipation.

3. Constipation or Slow Transit Colon:

This is caused by the reduced motility of the large intestine, which results in slow movement of wastes through it and excessive water absorption, making the stools dry and hard.

4. Gastroesophageal Reflux Disease (GERD):

GERD allows stomach acid to move up into the oesophagus due to impairment in the lower oesophagal sphincter.

5. Irritable Bowel Syndrome (IBS):

Causes of Gut Dysmotility

“Gut dysmotility can affect any part of the digestive tract. In each case, knowing the cause is the key to a cure.”

Gut dysmotility can be a result of the following:

Neurological Disorders:

• Conditions that affect your nervous system, like Parkinson’s disease, multiple sclerosis, or injuries to the spinal cord, can affect gut motility. How? This is because of the close communication between your brain and the gastrointestinal system, referred to as the gut-brain axis.

Damage to the vagus nerve (the longest cranial nerve in the body, also responsible for digestion) may cause gut dysmotility by disrupting the communication between your gut and brain.

Muscle Disorders:

• Diseases that affect the connective tissues and cause muscle stiffness, like scleroderma, can reduce the ability of your gut muscles to contract and impair normal peristalsis.

Diabetes:

• High blood sugar levels can damage the nerves and lead to poor coordination of gut muscle contractions, causing delayed gastric emptying (gastroparesis) and slow gut movements.

Medications:

• Certain groups of medications like opioids (morphine), anticholinergics (used to relieve cramps or spasms), antidepressants, and diuretics (medicines which increase urine production) can slow down gut motility.

Infections:

• Viral or bacterial infections may cause inflammation, nerve or muscle damage, changes in gut microbiome diversity and disrupt normal gut motility.

Hormonal Changes:

• Hormonal imbalances, such as hypothyroidism, can slow down metabolism, causing decreased energy supply to the gut, which leads to disruptions in gut motility.

Other Factors:

• Apart from these, stress, complications that arise after abdominal surgeries, trauma, sepsis, or autoimmune diseases like lupus, celiac disease, and inflammatory bowel disease (IBD) can also cause gut dysmotility.

Symptoms of Gut Dysmotility

Listen to what your body is telling you. If you notice these symptoms, it could be your body’s way of signalling an issue with your gut motility. Watch out for signs such as:

• Bloating and gas.
• Abdominal pain or discomfort.
• Constipation or diarrhoea.
• Feeling full quickly, even after a small meal (early satiety).
• Unintentional weight loss is brought on by poor nutrient absorption.
• Acid reflux or heartburn.
• Nausea and vomiting, especially after meals.
• Difficulty swallowing (if the oesophagus is affected).
• Lethargy or tiredness due to poor digestion and absorption of nutrients.

Did You Know?

Each one of you may have different symptoms of Gut Dysmotility according to your gut type. So it's time to find out!

What Type of Gut Do You Have?

Diagnosing Gut Dysmotility

“Dysmotility may occur in the small bowel and also in other areas of the gastrointestinal tract (e.g., oesophagus, stomach and colon) and their involvement may complicate diagnostic tests and treatments”

Doctors use a variety of diagnostic tests to confirm the diagnosis of intestinal dysmotility, such as:

Medical History and Physical Exam:

• What is the first thing that’s done on a doctor’s visit? Take a detailed medical history and talk about your symptoms, medications and supplements you’re taking and underlying health conditions. A physical examination might also be performed based on your symptoms.

Imaging Tests:

• X-rays and CT scans may be required to visualise the structure and movement of your gastrointestinal tract. These tests help identify structural abnormalities or to know if the symptoms are caused by pseudo-obstruction (a condition that mimics mechanical bowel obstruction but without any physical blockage).

Motility Studies:

• These tests assess how well your gastrointestinal tract is working. For example, the gastric emptying test measures the time taken by food to leave the stomach, and manometry measures the pressure and activities of the muscles and nerves of your gut.

Endoscopy or Colonoscopy:

• These procedures allow doctors to see the insides of your body using a long, flexible tube called an endoscope. This procedure is done to rule out structural changes, like growths, ulcers, strictures, or inflammation, and sometimes to obtain tissue samples for biopsy.

Blood Tests:

• You may also require blood tests to assess levels of nutrients and hormones or to check for infections. Blood tests can also help identify certain causes of gut dysmotility, like diabetes and lupus.

Treatment Options for Gut Dysmotility

Treatment of gut dysmotility is based on its type and what causes it. Solutions for gut dysmotility range from natural remedies like simple dietary and lifestyle changes to medications and advanced treatments. Let us explore these one by one:

1. Dietary Changes

• Eat smaller meals more frequently. This can reduce the stress on your digestive system, prevent bloating, and reduce the feeling of early satiety.
• In the case of gastroparesis (a condition that causes delayed emptying of food from your stomach to the small intestine), a diet low in fibre is beneficial as it is easier to digest and reduces the risk of phytobezoar (an undigested mass of plant material that forms in your gut).
• If you suffer from constipation, consuming a high-fibre diet can relieve the symptoms by increasing the bulk of stools, making it easier to pass. Whole grains, fruits and vegetables are good sources of fibre and support bowel movement.
• Drink plenty of water throughout the day. Water is essential for all bodily functions, including digestion. Drinking sufficient water can soften the stool, allowing it to pass smoothly.
• Avoid foods that may worsen your symptoms, like spicy, processed, oily, and sugary foods. These foods can irritate your gut lining and cause inflammation.

2. Medications

• Patients with gastroparesis may benefit from prokinetics (or medications that strengthen and increase the frequency of gut muscle contractions), such as erythromycin and metoclopramide (Reglan).
• Nausea and vomiting can be treated and prevented using antiemetics like ondansetron and promethazine.
• In case of severe constipation, laxatives or stool softeners can help by increasing the water content in the stool, making it softer and easier to pass.
• Antispasmodic drugs, which relax the gut muscles and decrease gut motility, can be used to effectively treat gut dysmotility if it is causing cramping or pain in the abdomen. Opioid antispasmodics can exacerbate stomach dysmotility; therefore, avoid using them to treat pain.

3. Lifestyle Modifications

“Sorry, there’s no magic bullet. You gotta eat healthy and live healthy to be healthy and look healthy. End of story.”

Here are some simple lifestyle changes that can effectively improve gut motility issues:

• Staying physically active and exercising can improve digestion and stimulate intestinal muscle contraction. Practise low to moderate-intensity exercises like swimming, jogging, or cycling. Avoid overexertion as it may worsen gut dysmotility.
• Stress results in alterations of gut-brain interactions, leading to disorders of the digestive tract. Stress-relieving techniques like yoga, meditation, and breathing exercises can reduce stress-related gut motility issues.
• Practise mindful eating habits. Chew your food thoroughly and avoid rushing through your meals. This can promote better digestion.

4. Advanced Treatments

If standard treatments like diet and lifestyle modifications and medications fail to provide relief from your symptoms, or if they get worse, advanced treatments might become necessary.

• For patients who are having difficulty consuming adequate nutrition orally, a feeding tube inserted through the nose into the stomach or small intestine can be used to deliver food and hydration.
• What is the best way to deliver nutrition when you’re unable to eat or drink or your digestive system cannot absorb nutrients from food? In conditions like severe motility or malabsorption issues, nutrition in the form of fluids is provided intravenously through your vein by bypassing your gastrointestinal tract. This is called parenteral nutrition.
• Electrical stimulation of the vagus nerve can enhance gut motility in treating conditions like gastroparesis or constipation. Enterra therapy is a gastric neurostimulator that has been approved for use in the treatment of gut dysmotility.
• If gut dysmotility is caused by severe physical obstructions or abnormalities in the gut, like adhesions or tumours, surgery is the treatment of choice.

5. Alternative and Natural Remedies

Numerous complementary and alternative treatments are used to treat gut-related disorders and to support gut health. These natural approaches can help reduce the symptoms of gut dysmotility while supporting your overall well-being:

Ginger:

• Ginger and its active constituents are proven to enhance gut motility. Studies have also shown that ginger is beneficial in relieving nausea and vomiting. How do you use it? You can either chew a piece of ginger, use it while preparing your meals, or make a herbal tea by boiling it in water.

Peppermint Oil:

• Studies have shown that peppermint oil is a safe herbal medicine for pain and other symptoms of IBS. It helps relieve cramps and bloating. You can add fresh peppermint leaves to food or use peppermint oil capsules.

Probiotics:

• Probiotics are live microbes that have health benefits when consumed. Probiotics in the form of food (fermented foods like yoghurt, kefir, sauerkraut, and kimchi) or supplements can improve the diversity of your gut microbiome, thereby supporting healthy gut motility and reducing inflammation.

Acupuncture:

• Studies have shown that acupuncture or electroacupuncture (a modern form of acupuncture that uses needles and small electric currents to treat diseases) is able to alter gastrointestinal motility functions and improve gastrointestinal motility disorders. These methods may improve symptoms by stimulating the nerves related to digestion.

Preventing Gut Dysmotility

Why go through all the hassle gut dysmotility brings with it? When you choose prevention, you never have to face this condition, and it can also enhance your overall gut health. How can you prevent gut dysmotility? Here are some expert-recommended tips for you:

• Maintain a balanced diet. Include fibre-rich foods like whole grains, fruits, and veggies. Also, drink plenty of water throughout the day to prevent dehydration.
• Manage underlying conditions like diabetes or thyroid disorders to reduce the risk of developing gut dysmotility.
• Avoid prolonged or overuse of medications like laxatives, pain-relieving medicines like NSAIDs, and antibiotics, as they impair gut motility.
• Lead a physically active lifestyle and exercise regularly to stimulate bowel movements.

The Bottom Line

Gut dysmotility is a condition that not only affects your digestive tract but also manifests in various systems, affecting your quality of life. All disease starts from your gut, which means it plays a central role in your overall health and well-being. Any disruption in its functioning can be troublesome and frustrating.

The symptoms need to be identified and treated early to prevent complications like malnutrition and electrolyte imbalances. Symptoms of gut dysmotility can be managed using simple diet and lifestyle changes and medications. In more severe cases, surgery can help.

Are your symptoms severe or persistent? If so, talk to a healthcare professional to identify the cause and plan a personalised treatment for you.

Heal Your Gut, Heal Your Body