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Neurology and the gastrointestinal system

G D Perkin1, I Murray-Lyon

  • 1Department of Neuroscience and Psychological Medicine, The Hammersmith Trust Hospitals, London, UK.

Journal of Neurology, Neurosurgery, and Psychiatry
|September 5, 1998
PubMed
Summary

Neurological disorders can manifest as gastrointestinal motility issues, such as achalasia and Hirschsprung

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Area of Science:

  • Gastroenterology
  • Neurology
  • Motility Disorders

Background:

  • Gastrointestinal motility disorders, including achalasia and Hirschsprung's disease, stem from neural innervation defects.
  • These conditions impact specific sections of the gastrointestinal tract, leading to motility dysfunction.
  • Numerous neurogenic and primary muscle disorders are linked to abnormal gut motility patterns.

Purpose of the Study:

  • To explore the intricate relationship between neurological conditions and gastrointestinal motility disturbances.
  • To highlight how neurological presentations can indicate primary gastrointestinal or neurological diseases.

Main Methods:

  • Review of existing literature on neurological disorders and their gastrointestinal manifestations.
  • Analysis of specific conditions like stroke, Chiari malformation, diabetes mellitus, and muscular dystrophies in relation to gut motility.
  • Examination of primary gut disorders associated with neurological disease, including nutritional deficiencies and autoimmune conditions.

Main Results:

  • Dysphagia is a common symptom in neurological disorders, sometimes being the primary feature (e.g., Chiari malformation).
  • Autonomic neuropathy in neurogenic disorders can cause small and large bowel motility disturbances, notably in diabetes mellitus.
  • Primary muscle disorders (e.g., Duchenne's muscular dystrophy) and nutritional deficiencies (e.g., pernicious anemia, vitamin deficiencies) can also affect gut motility and swallowing.

Conclusions:

  • Neurological and primary muscle disorders significantly influence gastrointestinal motility, presenting with diverse symptoms from dysphagia to bowel dysfunction.
  • Certain neurological presentations, like those in Whipple's disease, can be indicative of CNS-confined pathology.
  • Understanding these connections is crucial for accurate diagnosis and management of complex patient cases.

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