Disrupted bowel movements: mega guide on overlooked causes and what to do
A deep dive into the drivers of constipation, diarrhea and unpredictable bowel movements + what to do about them
Disrupted digestive motility is a much bigger issue than most people realize.
Since you’re reading this, I’m assuming you’ve already tried the usual advice for these issues: try a probiotic, supplement fiber or take one of the antidiarrhea or laxative supplements but didn’t fully resolve the issue.
Many people go days or even weeks without a bowel movement. It’s become so common that we don’t think it’s a big deal.
But if we had that level of dysfunction with any other organ system it would raise many red flags.
The truth is that this is a big problem.
So is the other end of the spectrum where people are having to plan their day around where the closest bathroom is due to unpredictable diarrhea.
Both extremes signal something is wrong under the surface.
Digestive motility is the coordinated muscle contractions that move food, fluids and waste through the digestive tract. From stomach churning to muscle and sphincter contractions throughout the intestines.
This system helps make sure we’re properly breaking down foods, absorbing nutrients and getting waste out of our body.
Motility is regulated by a complex system that primarily involves:
The enteric nervous system (referred to as our “second brain”)
Hormones (like motilin, ghrelin and thyroid hormones)
Neurotransmitters (such as serotonin, 90%+ of which is made in the gut)
Gut microbiome (regulates signaling, digestion and much more)
When motility is working normally, we don’t even think about it.
But when it’s off, either too fast or too slow, it usually brings bloating, cramping, pain, gas, diarrhea, constipation, etc. As well as a long list of downstream complications.
Disrupted motility can involve both too slow and too fast movement or the constant fluctuation between the two.
Here’s why both of these are a problem.
Why Slow Motility Is a Problem
When motility slows down, the colon absorbs too much water from the stool, making it hard, dry and difficult to pass. This can lead to not enough bowel movements and accumulation of toxins, byproducts and other harmful substances that can be reabsorbed.
Slow motility commonly causes bloating, gas, pain, irritability and other annoying symptoms. But it’s not just about the symptoms. When this goes on for an extended period, it commonly leads to other downstream issues.
Things like malabsorption and nutrient deficiencies, pathogen overgrowth, microbiome imbalances, gut lining damage, oxidative stress and inflammation often come into the picture when slow motility is an ongoing issue.
Chronic constipation and the straining that can come with it increases the risk of hemorrhoids, anal fissures and rectal prolapse as well. All of which can just lead to further motility disruptions (along with the pain).
And this progression of slowed motility leading to downstream issues can go on endlessly. For example, microbiome disruptions from slow motility can impact hormones, immune function, metabolic health and even cognitive issues.
Why Overactive Motility Is a Problem
With rapid motility, things move through the intestines too quickly for proper absorption. This usually causes loose, watery stools, urgency and feeling like you’re never fully digesting things.
Over time, this can deplete electrolytes and fluids, leading to dehydration, fatigue and muscle disruptions. Other nutrients beyond electrolytes are often depleted too due to the disruption of digestion and absorption.
This typically comes with abdominal pain and inflammation of the gut lining, which can cause or worsen issues like permeability or food sensitivities.
People with extremely fast motility sometimes even visibly see undigested food in their stool.
Chronic diarrhea can also lead to microbiome balance issues where beneficial bacteria are flushed out, creating an environment where pathogens can flourish and worsening inflammation, motility and other issues.
Whether too fast, too slow, or constantly fluctuating, disrupted motility doesn’t just affect your gut. It impacts your entire body.
It’s crucial to identify and address the root issues behind motility dysfunction, not just try to relieve bloating, pain or the constant need to be near a bathroom. This is the only way you get actual long-term relief and prevent the cascade of health complications it can cause.
Key Contributors to Disrupted Motility
Before diving into the specifics, it’s important to understand that disrupted motility is often caused by a single factor.
That’s why it’s essential to take a broad view when assessing your situation. Many different root causes can produce the same symptoms, so jumping to conclusions too quickly can lead to focusing on the wrong things.
Below are some of the most common (and many times interconnected) contributors.