Small intestine and colon motility

Motor abnormalities of the small and large intestine are common in both functional and organic gastrointestinal disorders. However, the presence of some of these patterns of dysmotility in healthy controls, the absence of correlation with symptoms, and the poor response to treatments has raised questions as to whether these are epiphenomena rather than pathophysiologically relevant events. This is especially the case in functional disorders, such as irritable bowel syndrome and slow-transit constipation, where disturbances of sensitivity and autonomic nerve activity are also important. In motility disorders with an organic basis, such as chronic intestinal pseudo-obstruction and Hirschsprung's disease, the presence of predictable abnormalities of colonic and small bowel motility has helped define the condition. Radiological proof of dilated small bowel remains the diagnostic gold standard of these conditions but serial MRI techniques are proving increasingly useful in the diagnosis and measurement of small bowel motility. The advent of prokinetic drugs that target gut serotonin may lead to the specific reduction of dysmotility and the symptoms it causes. Furthermore, recognition of the interplay between motility and sensory function in functional and organic gastrointestinal disorders has suggested a therapeutic role for electrical neuromodulation of spinal and gut reflexes.