Gastric and small intestinal motility in health and disease

Although symptoms possibly related to motor dysfunction appear to be common, primary disorders of the foregut motor apparatus, defined on the basis of a discrete myoneural pathology, are notably rare. This phenomenon may as much reflect the relatively primitive nature of diagnostic methods as the true rarity of such disorders. Although diagnostic methodologies increase in sophistication and availability, their clinical impact has been limited by an imperfect relationship between symptoms and dysfunction and by a relatively poor ability of such tests to predict response to available therapeutic strategies. An ever-increasing understanding of the complex, often interrelated motor and sensory phenomena that contribute to symptoms, together with the development of consensus on the use and interpretation of motility tests and the more widespread application of sophisticated histologic, immunologic, biochemical, and molecular biologic methodologies to the study of these disorders, should lead, in the years to come, to much needed progress in this area.