Clinical and Translational Aspects of Normal and Abnormal Motility in the Esophagus, Small Intestine and Colon

Motility is the process of moving luminal contents through the gastrointestinal (GI) tract. However, motility encompasses many complex processes and is influenced by many internal and external factors. While there is intrinsic or enteric nervous system, motility is also influenced by the central nervous system and the sympathetic and parasympathetic nervous systems, by the hormonal milieu by receptors throughout the GI tract, by luminal contents and by the microbiome of the GI tract. In health, this complex integrated system works seamlessly to transport liquid, solid, and gaseous contents through the GI tract sampling the contents and adjusting transport accordingly by speeding, slowing, or stopping the flow and by increasing or decreasing pressure within the sphincters. However, these complex integrated systems are subject to acute and chronic pathophysiologic changes that can lead to short-and/or long-term dysfunction.Rapid advances in technology have allowed the development of cutting edge diagnostic methods that can be applied to patients with functional motility disorders of the GI tract. These technologies and methods allow the clinician to investigate various aspects of motility. In this chapter, we will discuss recent diagnostic tests and cutting edge therapeutic advances aimed at diagnosing and treating functional motility disorders within the luminal GI tract of the esophagus, small intestine, and colon. The stomach will be discussed in another section.