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World J Gastroenterol. Jan 7, 2014; 20(1): 37-44
Published online Jan 7, 2014. doi: 10.3748/wjg.v20.i1.37
Gastrointestinal motility disorders in inflammatory bowel diseases
Gabrio Bassotti, Elisabetta Antonelli, Vincenzo Villanacci, Marianna Salemme, Manuela Coppola, Vito Annese
Gabrio Bassotti, Elisabetta Antonelli, Gastroenterology and Hepatology Section, Department of Clinical and Experimental Medicine, University of Perugia, 06156 Perugia, Italy
Vincenzo Villanacci, Marianna Salemme, Second Pathology Section, Spedali Civili of Brescia, 25100 Brescia, Italy
Manuela Coppola, Vito Annese, Gastroenterology Unit, Careggi University Hospital, 50134 Florence, Italy
Author contributions: Bassotti G and Annese V ideated the project; Bassotti G wrote the first draft of the manuscript; Antonelli E, Villanacci V, Salemme M, Coppola M and Annese V critically reviewed the manuscript; all authors read and approved the final version of the manuscript.
Correspondence to: Gabrio Bassotti, Professor, Gastroenterology and Hepatology Section, Department of Clinical and Experimental Medicine, University of Perugia, Ospedale Santa Maria della Misericordia, Piazzale Menghini 1, 06156 Perugia, Italy. gabassot@tin.it
Telephone: +39-75-5784423 Fax: +39-75-5847570
Received: July 18, 2013
Revised: September 16, 2013
Accepted: September 29, 2013
Published online: January 7, 2014
Abstract

The relationship between motility and inflammatory gastrointestinal disorders is at the same time complex and intriguing since these conditions might share some genetic, environmental, immunological and microbial predisposing factors. In addition, significant symptom overlapping may occur, muddling the waters within the clinical context. Although on one hand this represents a challenge for the clinician for a potential under- or over-treatment and diagnostic delay, on the other hand it possibly represents an opportunity for the researcher to better disclose the intimate relationship between chronic (often low-grade) inflammation, motor disorders and deranged sensory function. The best example is probably represented by Crohn’s disease and ulcerative colitis. In fact, a number of gastrointestinal motor disorders have been described in association with these diseases, disorders which span from the esophagus to the anorectum, and which will be extensively covered in this review. It is conceivable that at least part of this derangement is strictly related to inflammatory cytokine trafficking and neuromuscular changes; however, given the high prevalence of functional gastrointestinal disorders in the general population, this overlap might also be serendipitous. However, it is worth noting that literature data on this topic are relatively scarce, sometimes quite outdated, and mostly focused on the interplay between irritable bowel syndrome and inflammatory bowel disease. Nevertheless, both researchers and clinicians must be aware that symptoms related to gastrointestinal motility disorders may be highly prevalent in both active and inactive inflammatory bowel disease, correlate with greater psychological comorbidity and poorer quality of life, and may negatively influence the therapeutic approaches.

Keywords: Crohn’s disease, Gastrointestinal motility disorders, Gut, Inflammatory bowel diseases, Perception, Ulcerative colitis

Core tip: Gastrointestinal motor disorders are not infrequently associated with inflammatory bowel disease and may represent a confounding factor, especially when inflammation has subsided or the clinical picture is in remission. Since these entities may involve all the segments of the gastrointestinal tract, it is important that clinicians and researchers be aware of this potential overlap, since lack of knowledge may lead to mistreatment or overtreatment. However, literature data on this topic are relatively scarce and are extensively covered in this review.