Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 21, 2019; 25(31): 4414-4426
Published online Aug 21, 2019. doi: 10.3748/wjg.v25.i31.4414
Gastrointestinal motility and absorptive disorders in patients with inflammatory bowel diseases: Prevalence, diagnosis and treatment
Luísa Leite Barros, Alberto Queiroz Farias, Ali Rezaie
Luísa Leite Barros, Alberto Queiroz Farias, Department of Gastroenterology, University of São Paulo School of Medicine, São Paulo 05403-000, Brazil
Ali Rezaie, Division of Gastroenterology, Department of Medicine, Cedars Sinai Medical Center, Los Angeles, CA 90048, United States
Author contributions: All authors equally contributed to this paper with conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Conflict-of-interest statement: This review was conducted without any financial support. LLB and AQF report not relevant conflict of interest. AR has served as a speaker and consultant and has received research grants from Bausch Health. AR has equity in Gemelli Biotech. Cedars-Sinai Medical Center has a licensing agreement with Bausch Health and Gemelli Biotech. AR has served as consultant for GutHub.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Ali Rezaie, FRCP (C), MD, MSc, Assistant Professor, Director GI Motility Program, Division of Gastroenterology, Department of Medicine, Cedars Sinai Medical Center, Cedars-Sinai, 8730 Alden Drive, Thalians Bldg, E226, Los Angeles, CA 90048, United States.
Telephone: +1-310-423-8711
Received: May 2, 2019
Peer-review started: May 4, 2019
First decision: May 24, 2019
Revised: July 4, 2019
Accepted: July 19, 2019
Article in press: July 19, 2019
Published online: August 21, 2019

Inflammatory bowel diseases (IBD), Crohn`s disease and ulcerative colitis, are chronic conditions associated with high morbidity and healthcare costs. The natural history of IBD is variable and marked by alternating periods of flare and remission. Even though the use of newer therapeutic targets has been associated with higher rates of mucosal healing, a great proportion of IBD patients remain symptomatic despite effective control of inflammation. These symptoms may include but not limited to abdominal pain, dyspepsia, diarrhea, urgency, fecal incontinence, constipation or bloating. In this setting, commonly there is an overlap with gastrointestinal (GI) motility and absorptive disorders. Early recognition of these conditions greatly improves patient care and may decrease the risk of mistreatment. Therefore, in this review we describe the prevalence, diagnosis and treatment of GI motility and absorptive disorders that commonly affect patients with IBD.

Keywords: Inflammatory bowel diseases, Crohn’s disease, Ulcerative colitis, Gastrointestinal motility and absorptive disorders, Irritable bowel syndrome, Small intestinal bacterial overgrowth, Small intestinal fungal overgrowth, Dyssynergic defecation, Fecal incontinence, Chronic intestinal pseudo-obstruction

Core tips: Gastrointestinal motility and absorptive disorders such as small intestinal bacterial overgrowth, carbohydrate malabsorption or dyssynergic defecation are highly prevalent in inflammatory bowel diseases (IBD) patients and often explain refractory symptoms in inactive disease. Prompt diagnosis of these conditions improves patient care and may decrease the risk of mismanagement in IBD population. In the present manuscript we provide a comprehensive review of the prevalence, diagnosis and the best management strategies of these disorders.