Guts and their motions (gastrointestinal motility in health and disease)

In the last decade, a much greater understanding of human upper intestinal motility has been obtained. The existence of a cyclical fasting pattern is now recognized, associated with intermittent secretion and propulsion of material through the stomach and small intestine. This pattern changes after the ingestion of food, the duration of the disruption depending upon both quality and quantity of nutrient ingested. The present clinical relevance of this phenomenon is twofold. 1) In normal fasting persons, the passage and absorption by the small intestine of food and drugs may be influenced by such periodic changes. 2) Motility abnormalities in disease states may account for associated gastrointestinal symptoms. While the number of disorders showing clinically relevant motor dysfunction is small, continuing study will undoubtedly bring others to light, and may even provide a rational basis for therapy.