Gastrointestinal motility in acute illness.

Area of Science:

• Gastroenterology
• Critical Care Medicine
• Neurogastroenterology

Background:

• Critical illness frequently causes gastrointestinal (GI) motility disturbances, both as a primary issue and a complication during intensive care unit (ICU) stays.
• Motility problems stem from impaired GI muscle, pacemaker cells, or nerve activity, notably involving the enteric nervous system (ENS), the brain's 'second brain'.
• The ENS independently regulates complex GI motility patterns, but imbalances between excitation and inhibition lead to severe functional derangements.

Purpose of the Study:

• To review common GI motility disturbances in critically ill patients, including gastroparesis, postoperative ileus, and Ogilvie's syndrome.
• To discuss generally effective treatment methods for these conditions.
• To explore strategies for preventing or mitigating GI motility disturbances in the ICU setting.

Main Methods:

• This is a review article, synthesizing existing knowledge on GI motility in critical illness.
• Focuses on the pathophysiology of motility disturbances related to neural control, particularly the ENS.
• Examines clinical presentations, treatments, and preventative measures for specific motility disorders.

Main Results:

• GI motility disturbances are common in critical illness and affect all GI tract segments.
• Gastroparesis, postoperative ileus, and Ogilvie's syndrome are key examples of these disorders.
• Effective treatments exist, and preventative strategies can reduce the severity and incidence of these complications.

Conclusions:

• Understanding the neural control of GI motility is crucial for managing critically ill patients.
• Timely diagnosis and appropriate management of motility disorders can improve patient outcomes.
• Proactive strategies are essential to prevent or minimize the impact of GI dysmotility during and after ICU care.