Intestinal dysmotility

What is intestinal dysmotility?

To move through the digestive tract, food is pushed along by coordinated contractions, controlled by the nerves and muscles of the bowel wall. We speak of dysmotility when these contractions are slowed, weakened or disorganised, without any blockage in the way.

It can affect the small intestine, the colon or both, and occur together with gastroparesis when the stomach is also involved. Its severity ranges from very slow transit to chronic intestinal pseudo-obstruction, a rare disease in which the bowel behaves as if it were blocked.

It can be linked to another disease (diabetes, scleroderma, neurological or muscle disease), to certain medicines (especially opioids), or have no identified cause.

Ruling out a blockage, then measuring transit

The first step is to check that no mechanical blockage explains the symptoms, using imaging (CT scan, MRI) and sometimes an endoscopy.

Depending on the situation, other tests can then assess digestive motility:

• colonic transit time, using markers visible on X-ray;
• manometry, which measures contractions of the small intestine or colon;
• a scintigraphy or a capsule that tracks progress through the digestive tract;
• blood tests to look for an associated disease.

These tests are often carried out in departments specialising in digestive motility.

EDS and digestive motility

Digestive problems are common in people with EDS, especially the hypermobile type: reflux, bloating, constipation, slow digestion. Motility disorders of the stomach and bowel have been described in some of them.

Several explanations have been suggested, such as fragility of the connective tissue in the gut wall or an associated dysautonomia, but the mechanisms are still being studied. As with gastroparesis, other causes must always be looked for.