Gastrointestinal motility disorders in neurologic disease

J Clin Invest. 2021 Feb 15;131(4):e143771. doi: 10.1172/JCI143771.

Abstract

The extrinsic and autonomic nervous system intricately controls the major functions of the gastrointestinal tract through the enteric nervous system; these include motor, secretory, sensory, storage, and excretory functions. Disorders of the nervous system affecting gastrointestinal tract function manifest primarily as abnormalities in motor (rather than secretory) functions. Common gastrointestinal symptoms in neurologic disorders include sialorrhea, dysphagia, gastroparesis, intestinal pseudo-obstruction, constipation, diarrhea, and fecal incontinence. Diseases of the entire neural axis ranging from the cerebral hemispheres to the peripheral autonomic nerves can result in gastrointestinal motility disorders. The most common neurologic diseases affecting gastrointestinal function are stroke, parkinsonism, multiple sclerosis, and diabetic neuropathy. Diagnosis involves identification of the neurologic disease and its distribution, and documentation of segmental gut dysfunction, typically using noninvasive imaging, transit measurements, or intraluminal measurements of pressure activity and coordination of motility. Apart from treatment of the underlying neurologic disease, management focuses on restoration of normal hydration and nutrition and pharmacologic treatment of the gut neuromuscular disorder.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Diabetic Neuropathies* / complications
  • Diabetic Neuropathies* / drug therapy
  • Diabetic Neuropathies* / pathology
  • Diabetic Neuropathies* / physiopathology
  • Enteric Nervous System* / drug effects
  • Enteric Nervous System* / pathology
  • Enteric Nervous System* / physiopathology
  • Gastrointestinal Diseases* / drug therapy
  • Gastrointestinal Diseases* / etiology
  • Gastrointestinal Diseases* / pathology
  • Gastrointestinal Diseases* / physiopathology
  • Gastrointestinal Motility*
  • Humans