So you’re being treated for a digestive disorder and are learning a lot about how all the anatomy works (perhaps even more than you cared to know!). Or perhaps you aren’t sure what you have but you’re struggling with a myriad of digestive symptoms such as chronic constipation, bloating, vomiting, nausea, or upper abdominal pain after eating. Digestive disorders and digestive symptoms often have a common thread among them that is easily treatable.
One aspect of our digestive system is very important but rarely gets the attention it should. What I’m talking about has likely played a large roll in the development of your digestive concerns in the first place. What is this important topic? Motility.
Motility is simply the movement of your digestive organs that brings food down, through each stage of digestion until it is eliminated. Specifically, motility is the muscular movements and contractions of your esophagus, stomach, small intestine, and large intestine.
Migrating Motor Complex (MMC)
When motility occurs in the stomach and small intestine it is part of what’s called the “migrating motor complex (MMC).” This complex moves (or migrates) food down the digestive tract using muscular contractions (motor) in a cyclic pattern. This pattern of contractions only occurs while fasting, sleeping, or when there’s a long enough time between meals.
The MMC begins moving food down 1.5 to 2 hours after we eat and takes approximately an hour and 45 minutes to complete the entire phase. This process is interrupted as soon as you eat food!
When the nerves or muscles of digestive organs are not working properly, motility is stalled and people can suffer from a range of symptoms as well as digestive disorders:
Symptoms of Impaired Motility
- Indigestion or heartburn
- Severe constipation
- Recurrent vomiting
Digestive Disorders Associated With Impaired Motility
- Gastroesophageal Reflux Disease (GERD)
- Achalasia (swallowing disorder)
- Functional Chest Pain
- Gastroparesis (delayed gastric emptying)
- Dumping Syndrome (rapid gastric emptying)
- Cyclic Vomiting Syndrome
- Intestinal Dysmotility
- Small Intestine Bacterial Overgrowth (SIBO)
- Irritable Bowel Syndrome (IBS)
- Fecal Incontinence
- Hirschsprung’s Disease (megacolon, unable to pass stool)
- Outlet Obstruction Syndrome (straining muscles fail to relax)
MMC and SIBO
We blog a lot about SIBO on this site, so it deserves a special mention as it relates to the migrating motor complex (MMC). As we learned, the MMC is the cyclic contractions of the stomach and small intestine that pushes food through our digestive tract. When this process is disrupted, it can cause intestinal dysmotility over time. This impaired motility plays into the severity of SIBO symptoms such as diarrhea, abdominal pain, and bloating.
Secondly, when your small intestine is not having its regular MMC contractions, food (and bacteria) become stagnated in place and the risk of bacterial overgrowth (SIBO) increases dramatically. Thus, the MMC not only controls motility of food through our system, but it also acts as an intestinal housekeeper, controlling bacterial growth in our small intestine by migrating it towards our large intestine where it should be. Therefore, it is critical to correct any impaired motility as part of your SIBO treatment.
How to Promote Healthy Motility
Motility regulation should be part of any treatment for digestive disorders. Anybody with SIBO, IBS, bacterial overgrowth, constipation, or very slow transit time of food through the gut, can benefit from the stimulation of healthy motility.
There are several ways to induce motility and promote our MMC to having regular contractions. One way is to take a prokinetic. Prokinetics are supplements or medications that promote motility and help manage associated symptoms.
Prokinetic medications have several unintended side effects, specifically affecting mood, digestive discomfort, sleep quality, energy levels, and appetite.
Prokinetic supplements are herbal remedies that have been long used to promote gut motility. Some examples of prokinetic herbs are: ginger, milk thistle, lemon balm, peppermint, licorice root, ginseng, and various herbal fruits and dried roots. Prokinetic supplements are usually proprietary blends of several herbs. They work together to activate contractions of the gut muscles, speed up stomach emptying, and act as anti-inflammatory agents. Prokinetics also provide relief for multiple digestive symptoms.
Make sure to talk with our team at Healthy Connections to ensure you are taking the right prokinetic and at the right time in your treatment schedule.
Other ways to promote healthy motility is to reduce your stress levels. Stress disrupts many of our body’s normal processes, including digestion. Chronic psychological stress slows digestion and can lead to constipation and a slowed MMC. Relaxation techniques help lower our stress levels. Try meditation, deep breathing, and yoga or gentle stretching to ease your stress.
As we learned, the MMC is activated by having an empty stomach. MMC contractions take place 1.5 to 2 hours after we eat, as well as overnight. The whole process lasts for an hour and 45 minutes, provided that food is not eaten during this time! To give your MMC the best chance at doing its job, its best to wait at least 3 hours and 45 minutes between meals/snacks. Any food eaten within this time frame will disrupt your MMC. Most beverages will also disrupt this process, however black coffee, herbal teas, and water, are all okay to have between meals. This can be a difficult habit adopt, but it will work wonders for your digestion! When practicing meal spacing, it’s best to eat nutrient-dense meals that won’t leave you hungry in an hour. Eating only grains (like cereal or toast for breakfast) will not be filling enough and you’ll be ready for a snack soon after. Instead, maximize each meal by including healthy fat, protein, and high-fiber vegetables. This will create long-lasting satiety (fullness) for several hours without feeling the need to snack.
Not everyone should practice meal spacing however. Infants, children, and pregnant women should eat more frequently to meet their growing nutrient needs. Those with diabetes are also excluded as they usually need to eat more often to balance their blood sugar.
Our MMC not only works between meals on an empty stomach. It also works overnight while we are sleeping. For this reason, a 12 hour overnight fast will allow our MMC to work effectively without regular food interruptions. An example of a 12 hour overnight fast would be to finish eating dinner at 7-8pm, going to sleep, and then eating breakfast between 7-8am the next morning. This is not an unusual routine for most people, so you might find that going 12 hours with overnight fasting isn’t difficult to achieve.
Motility and the actions of our MMC play a crucial role in our digestive system. They ensure that the food we eat gets moved through our GI tract at the proper speed, which in turn prevents bacteria from stagnating in one place and causing an overgrowth. Having proper motility will prevent (and treat) digestive disorders, like SIBO, as well as a myriad of GI symptoms such as constipation, bloating, and abdominal pain. Prokinetic supplements are herbs that activate motility in our gut and are useful for treating digestive disorders. Stress management, meal spacing, and overnight fasting are other ways we can promote healthy motility. Talk to our team at Healthy Connections on how your motility might be paying a part in your digestive symptoms!