Colonic Motility in the Irritable Bowel Syndrome

Abstract

Problems encountered by physicians in the management of the irritable bowel syndrome (IBS) are among the most frustrating in clinical medicine. This common disorder accounts for over half of all referrals to gastroenterologists and is a major cause of absenteeism in the work force.¹ Although the syndrome involves more than just the intestinal tract as its title would imply, the symptoms of painless diarrhea, abdominal cramping pain and constipation, or alternating diarrhea and constipation suggest that alterations in intestinal motor function are important in its pathogenesis. Three decades of research concerned mainly with colonic motility in IBS has demonstrated several abnormalities in these patients when compared with normal subjects. It is the objective of this report to review these abnormal motility patterns and consider what therapeutic measures might reasonably be expected to help restore them to normal. The discussion will include normal colonic motility, the various motility disturbances in