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2.1
Abnormal Gastrointestinal Motility

Presentation

CONCLUSIONS: Abnormalities in GI motility may be an early presenting sign of disorders of OXPHOS in children. [ncbi.nlm.nih.gov]

CONCLUSION: Abnormalities in GI motility may be an early presenting sign of disorders of OXPHOS in children. [nature.com]

Gastrointestinal abnormalities may be an early presenting sign of mitochondrial disease (Chitkara, 2003). [mitoaction.org]

The presenting faculty reported the following: Dr. [consultant360.com]

Entire Body System

  • Fatigue

    Muscle weakness or fatigue of the muscles of mastication can directly interfere with the physical intake of adequate calories. [mitoaction.org]

    Reference: Burnet R B, Chatterton B: Gastro-Intestinal Symptoms and Gastric Emptying Studies in Chronic Fatigue Syndrome; AHMF Conference 2001. [digestivedistress.com]

    […] symptoms include: A change in normal bowel habits Blood on or in the stool that is either bright or dark Unusual abdominal or gas pains Very narrow stool A feeling that the bowel has not emptied completely after passing stool Unexplained weight loss Fatigue [my.clevelandclinic.org]

Gastrointestinal

  • Nausea

    Read More about Gastropareis Cyclic vomiting syndrome (CVS) Cyclic vomiting syndrome (CVS) is a disorder with recurrent episodes of severe nausea and vomiting interspersed with symptom free periods. CVS occurs in all ages. [aboutgimotility.org]

    Delayed gastric emptying most commonly gives rise to abdominal discomfort after meals, nausea and vomiting. The two most common causes of delayed gastric emptying are gastric outlet obstruction and gastroparesis. [medicinenet.com]

    Most people with gastroparesis experience nausea and vomiting. Many have abdominal discomfort or pain, which can range from bothersome to debilitating. [iffgd.org]

    Symptoms depend on which area of the digestive tract that is involved, and may include: Abdominal pain or swelling Difficulty swallowing Reflux (or back up of food in the throat) Burping Regurgitation A feeling of early fullness Nausea Vomiting Weight [columbiadoctors.org]

    Patients with gastroparesis may present with early satiety, nausea, vomiting, bloating, postprandial fullness, or upper abdominal pain. [aafp.org]

  • Abdominal Pain

    It also provides global relief of IBS symptoms (eg, abdominal pain/discomfort, diarrhea, and urgency) in patients with IBS with diarrhea. [pharmacytimes.com]

    At times, enteric neuropathy may lead to a chronic abdominal pain syndrome similar to the pain of peripheral neuropathy in the feet. [journal.diabetes.org]

    Mitochondrial disease should be part of the differential diagnosis for individuals with dysmotility, chronic diarrhea, constipation or chronic abdominal pain (Chitkara, 2003). [mitoaction.org]

    These symptoms range from nausea, vomiting, belching, reflux (stomach acid washing into the mouth), early satiety (a feeling of fullness after a few bites of food), abdominal pain or bloating, a change in bowel habits, and weight loss. [digestivedistress.com]

    Symptoms depend on which area of the digestive tract that is involved, and may include: Abdominal pain or swelling Difficulty swallowing Reflux (or back up of food in the throat) Burping Regurgitation A feeling of early fullness Nausea Vomiting Weight [columbiadoctors.org]

Workup

The workup and treatment of diarrhea is similar in patients with or without diabetes. [journal.diabetes.org]

Treatment

Hyman Abstract Background In chronically ill children who refuse to eat, surgery to correct anatomic problems and behavioral treatments to overcome oral aversion often succeed. A few patients fail with standard treatments. [doi.org]

A few patients fail with standard treatments. [journals.lww.com]

Tegaserod is the only agent indicated by the FDA for the treatment of women with IBS with constipation, and alosetron is the only FDA-approved treatment for women with IBS with diarrhea. [pharmacytimes.com]

If these treatments don't relieve pain, surgery might be needed to repair the sphincter muscle. [my.clevelandclinic.org]

This must be done because treatment of pseudo-obstruction and true obstruction are very different. [ddc.musc.edu]

Prognosis

Prognosis Primary intestinal motility disorders or disorders that are not secondary to malignancy or debilitating pathology have a good prognosis. [emedicine.medscape.com]

Ultrasonography or computed tomography showing characteristic changes in a patient who uses little or no alcohol confirms the diagnosis. 24 CLINICAL FEATURES, COURSE, AND PROGNOSIS Most patients with nonalcoholic fatty liver disease are asymptomatic. [aafp.org]

Etiology

But the etiology of the intestinal motility disorders cannot be fully explained by physiological causes alone. [pennmedicine.org]

Gastric Emptying Study Center Medically Reviewed on 6/14/2018 References Medically reviewed by Venkatachala Mohan, MD; Board Certified Internal Medicine with subspecialty in Gastroenterology REFERENCE: "Gastroparesis: Etiology, clinical manifestations [medicinenet.com]

Hyperglycemia and poor glycemic control play a substantial role in gastroparesis, both as an etiologic factor and a clinical manifestation. [consultant360.com]

GASTRIC MUCOSAL ISCHEMIA : Ischemia of mucosa causes increased permeability ------> Gastric Ulcers Etiology: Lots of things; shock, burns, sepsis, trauma. [kumc.edu]

Sometimes an empiric trial of antibiotics and/or pancreatic enzymes is warranted because pancreatic exocrine insufficiency and bacterial overgrowth may be the etiology. [journal.diabetes.org]

Epidemiology

Epidemiology According to some epidemiologic reports, as many as 30 million Americans have intestinal motility disorders. [emedicine.medscape.com]

EPIDEMIOLOGY A constellation of GI symptoms occurs commonly in persons with diabetes and may be caused by autonomic dysfunction, as well as by other factors. [consultant360.com]

Pathophysiology

The aims of the study were to: 1) investigate motility and gastric sensory abnormalities and 2) describe treatment that was individualized based on pathophysiology in children who failed surgery and behavioral treatments. [doi.org]

The pathophysiology of these gastrointestinal symptoms, clarified in recent studies, and the clinical features and treatment of these problems in diabetic patients are reviewed. FULL TEXT [annals.org]

PATHOPHYSIOLOGY There are a number of different causes of gastroparesis ( Table I3 ), yet the underlying pathophysiology remains unclear. [consultant360.com]

Despite the important consequences that malfunction of the GI tract has for PD patients, there is a dearth of information concerning the pathophysiology and treatment of GI symptoms in PD because there is no laboratory model known to mimic the GI symptoms [michaeljfox.org]

Although conventional wisdom holds that these disorders lack a well-defined pathophysiology or specific therapy, Mayo Clinic gastroenterologists note that a careful clinical assessment integrated with the results of refined diagnostic tests is extremely [mayoclinic.org]

Prevention

Achalasia – prevents the sphincter from opening and allowing food to enter the stomach. Gastro-esophageal reflux disease (GERD) – caused by the stomach’s acidic contents leaking backwards up into the esophagus. [winthrop.org]

Aspiration of food is prevented: Respiration is inhibited from this point forward. Epiglottis is NOT important in preventing aspiration. Rather it is adduction vocal cords that prevents food getting into trachea.. [kumc.edu]

Learn More about Constipation Outlet obstruction type constipation (pelvic floor dyssynergia) The external anal sphincter, which is part of the pelvic floor normally stays tightly closed to prevent leakage. [iffgd.org]

This sensation of rectal filling enables us to consciously or unconsciously squeeze the external anal sphincter to prevent incontinence until we can reach a toilet. [drossmangastroenterology.com]

Can gastrointestinal disease be prevented? Many diseases of the colon and rectum can be prevented or minimized by maintaining a healthy lifestyle, practicing good bowel habits, and submitting to cancer screening. [my.clevelandclinic.org]

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