Perspectives

Abstract

Gastrointestinal mechanics and motility continues to be probably the least rationally developed subject in medical physiology. The significance of this deficit lies in the prominence of disordered gastrointestinal motor function in clinical medicine. Such disorders constitute the root problem in most patients with gastrointestinal complaints. Nearly all oesophageal disease, for example, represents abnormal mechanics in that organ. Diverticulosis of the colon, an increasing problem in the ageing population, arises from motor dysfunction. Motor abnormality contributes importantly to gallstone disease. The many forms of the pseudo-obstruction syndrome arise from poorly understood defects in gastrointestinal motility. Motor disorders undoubtedly complicate and account for some of the most troublesome symptoms in the inflammatory bowel diseases. Irritable bowel syndrome, the commonest gastroenterological diagnosis made in general office practice, represents undefined gastrointestinal neuromuscular dysfunction where we need new tools developed on a rational bioengineering approach. Motor disorders often complicate long-standing diabetes, several connective tissue diseases, and many neurological disorders. The ubiquity and persistence of such clinical problems, together with our inability to deal with them rationally, leaves a vast population of chronically ill people who must deal daily with defective gastrointestinal functions with little hope of relief.