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eric, when are they going to have a discussion about motility? I have sent a suggestion to them. Can you suggest it too please?And would it be out of line to discuss motility at length if the chat is about nausea?
 

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Bonniei, they have had a lot of chats in regards to IBS and motility.However, just fyi, motility is just a word that describes the contractions of muscles in the gi tract.Abnormal motility would be d or d/c or c for example. http://www.med.unc.edu/wrkunits/2depts/med...dc/motility.htm Hope that helps some.If I were you I would just check the chats out for the information as its all related to IBS for the most part and they can shed a lot of light on the subjects.By the way I never got an email from you, so you know.
 

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eric, remember my email. I don't know if you got it but it was mainly to ask you to comment on the "pain, gas, do I have ibs" in the gas forum.flux says abnormal motility has been established only for a subset of patients. He says that if abnormal motility had been established for everyoone then you would have an identifiable, objective problem and it would no longer be IBS. Any comments on that?
 

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Bonniei,"MotilityIn healthy subjects, stress can increase motility in the esophagus, stomach, small and large intestine and colon. Abnormal motility can generate a variety of GI symptoms including vomiting, diarrhea, constipation, acute abdominal pain, and fecal incontinence. Functional GI patients have even greater increased motility in response to stressors in comparison to normal subjects. While abnormal motility plays a vital role in understanding many of the functional GI disorders and their symptoms, it is not sufficient to explain reports of chronic or recurrent abdominal pain." http://www.med.unc.edu/wrkunits/2depts/med...aldisorders.htm Report on the 5th International Symposium on Functional Gastrointestinal Disorders There is a growing understanding of the multi-faceted nature of functional gastrointestinal disorders. Symptoms, behaviors, and treatment outcomes for individuals with these disorders relate to disturbances in gastrointestinal motility and sensation that is effected by interactions that take place via the brain-gut axis. To understand and study these conditions, physicians and researchers must become familiar with new and evolving knowledge that integrates basic science, physiology, clinical medicine, and psychology. A summary of major topics is presented. http://www.aboutibs.org/Publications/currentParticipate.html Hope that helps.
 

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Yes Bonniei, "PRESENT PATHOPHYSIOLOGICAL OBSERVATIONS Despite differences among the functional gastrointestinal disorders, in location and symptom features, common characteristics are shared with regard to:motor and sensory physiology, central nervous system relationships, approach to patient care. What follows are the general observations and guidelines. MotilityIn healthy subjects, stress can increase motility in the esophagus, stomach, small and large intestine and colon. Abnormal motility can generate a variety of GI symptoms including vomiting, diarrhea, constipation, acute abdominal pain, and fecal incontinence. Functional GI patients have even greater increased motility in response to stressors in comparison to normal subjects. While abnormal motility plays a vital role in understanding many of the functional GI disorders and their symptoms, it is not sufficient to explain reports of chronic or recurrent abdominal pain.Visceral HypersensitivityVisceral hypersensitivity helps to account for disorders associated with chronic or recurrent pain, which are not well correlated with changes in gastrointestinal motility, and in some cases, where motility disturbances do not exist. Patients suffering from visceral hypersensitivity have a lower pain threshold with balloon distension of the bowel or have increased sensitivity to even normal intestinal function. Additionally, there may be an increased or unusual area of somatic referral of visceral pain. Recently it has been concluded that visceral hypersensitivity may be induced in response to rectal or colonic distension in normal subjects, and to a greater degree, in persons with IBS. Therefore, it is possible that the pain of functional GI disorders may relate to sensitization resulting from chronic abnormal motor hyperactivity, GI infection, or trauma/injury to the viscera. Brain-Gut AxisThe concept of brain-gut interactions brings together observations relating to motility and visceral hypersensitivity and their modulation by psychosocial factors. By integrating intestinal and CNS central nervous system activity, the brain-gut axis explains the symptoms relating to functional GI disorders. In other words, senses such as vision and smell, as well as enteroceptive information i.e. emotion and thought have the capability to affect gastrointestinal sensation, motility, secretion, and inflammation. Conversely, viscerotopic effects reciprocally affect central pain perception, mood, and behavior. For example, spontaneously induced contractions of the colon in rats leads to activation of the locus coeruleus in the pons, an area closely connected to pain and emotional centers in the brain. Jointly, the increased arousal or anxiety is associated with a decrease in the frequency of MMC activity of the small bowel possibly mediated by stress hormones in the brain. Based on these observations, it is no longer rational to try to discriminate whether physiological or psychological factors produce pain or other bowel symptoms. Instead, the Functional GI disorders are understood in terms of dysregulation of brain-gut function, and the task is to determine to what degree each is remediable. Therefore, a treatment approach consistent with the concept of brain-gut dysfunction may focus on the neuropeptides and receptors that are present in both enteric and central nervous systems. The Role for Psychological FactorsAlthough psychological factors do not define these disorders and are not required for diagnosis, they are important modulators of the patient's experience and ultimately, the clinical outcome. Research on the psychosocial aspects of patients with functional GI disorders yields three general observations: Psychological stress exacerbates gastrointestinal symptoms in patients with functional GI disorders and can even produce symptoms in healthy patients but to a lesser degree. Psychological disturbances modify the experience of illness and illness behaviors such as health care seeking. For example, a history of major psychological trauma e.g. sexual or physical abuse is more common among patients seen in referral centers than in primary care and is associated with a more severe disorder and a poorer clinical outcome. Additionally, psychological trauma may increase pain-reporting tendency. Having a functional GI disorder has psychological consequences in terms of one's general well-being, daily functional status, concerns relating to control over symptoms, and future implications of the illness e.g. functioning at work and home. "
 
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