Intestinal dysmotility and the irritable bowel syndrome

Though reports of dysmotility from various parts of the gastrointestinal tract abound in IBS, the true significance of these abnormalities remains unclear. Many of these patterns are non-specific, and their description need not imply enteric neuropathy or myopathy or autonomic nervous dysfunction. Thus, it appears equally likely that these abnormal patterns could reflect abnormalities in sensation (afferent nerve dysfunction), perception (within the CNS), or central "drive" (to the gut). The interpretation of motility studies is further confounded by the lack of a "gold standard" for IBS and by variations in the definition of IBS between studies, rendering it likely that one is comparing different populations (24). Studies of motor activity in clearly defined IBS patient populations and appropriate controls are needed - such studies should attempt to correlate motility with symptoms and gut function and should take into account the possible contributions of stress, psychopathology and sensory dysfunction.