# Role of motility in chronic diarrhoea.



## eric (Jul 8, 1999)

Neurogastroenterol Motil. 2006 Dec;18(12):1045-1055. Role of motility in chronic diarrhoea.Spiller R.Wolfson Digestive Diseases Centre, University Hospital, Nottingham, UK.Patients complaining of 'chronic diarrhoea' usually mean the passage of loose, urgent stools. Chronic diarrhoea is a feature of malabsorption; it may also be seen in the 'dumping syndrome' which follows gastric surgery, small intestinal bacterial overgrowth, bile salt malabsorption and in malabsorption of simple sugars including most commonly lactose, fructose and sorbitol. Excessively rapid entry of chyme into the small or large intestine generates propulsive motor patterns leading to accelerated transit. Inflammation is associated with decreased normal mixing motor patterns but increased propulsive motility including high amplitude propagated contractions (HAPCs). Evidence for abnormal small intestinal motility in the diarrhoea associated with irritable bowel syndrome (IBS) is conflicting and any difference appears small. Increased colonic HAPCs with increased propulsion is seen in IBS with diarrhoea (IBS-D). Stress-induced colonic motility is increased in IBS-D with hyper-responsiveness to corticotrophin releasing factor (CRF). Long-lasting increases in mucosal serotonin availability may contribute to the chronic diarrhoea seen in IBS-D and coeliac disease. Treatments for abnormal motility in chronic diarrhoea include those designed to correct specific underlying abnormalities including octreotide, antibiotics, colestyramine, specific food avoidance and anti-inflammatory agents. There are also treatments aimed primarily at altering motility directly including opiates, 5HT3 receptor antagonists and amitriptyline.PMID: 17109687


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## 15221 (Dec 7, 2005)

Nice article, thank you Eric... I was always a little bit obsessed with food being the number one culprit and maybe it does have a shared eiteology with IBS, but it is far from the sole contributing factor seen in Celiac and IBD, Crons and UC....There has been much doubt but I must say your tireless reserch postings have finally helped me see a bigger picture with IBS....for me IBS encompasses many facets of the other diseases but other elements than cannot be addressed by diet alone....if I could only find a Dr. that would address these major findings and address these same revelations...Again.... thanks Eric


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## eric (Jul 8, 1999)

Noguts I am glad I could be of help.This Spiller DR is one if not the leading expert on PI IBS. He works in the UK but also works with DR's over here in the US. They are finding issues that need to be sorted out for sure. They are working on a CRF drug for one. But others as well like probiotics or serotonin drugs. All these things may play roles.There are also learning more about how relaxation techniques, CBT and HT and other methods work for IBS. This is important also as meds may or maynot be the only answers.


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