Tarmmotorik

Tarmmotorik, or intestinal motility, refers to the coordinated contractions of the smooth muscle in the gastrointestinal tract that move, mix, and regulate the contents of the gut. This motility is produced by rhythmic contractions in different patterns, including peristalsis, which propels contents, and segmentation, which promotes mixing and contact with the mucosa. Proper tarmmotorik depends on the integrity of the enteric nervous system, pacemaker activity, smooth muscle function, and hormonal regulation.

Physiology and regulation: The enteric nervous system, with the myenteric (Auerbach) and submucosal (Meissner) plexuses, coordinates contractions. Interstitial cells of Cajal act as slow-wave pacemakers that set contraction frequency. Distinct regions exhibit characteristic patterns: the small intestine performs segmentation and migrating motor complexes during fasting, while the colon uses haustral movements and propulsive waves. Hormones and neurotransmitters such as motilin, serotonin (5-HT), and ghrelin influence motility, and autonomic input via the vagus nerve modulates it.

Clinical relevance: Disrupted tarmmotorik can lead to slowed transit (ileus or constipation) or accelerated transit (diarrhea). Common disorders include gastroparesis, functional bowel disorders, intestinal pseudo-obstruction, and obstructive states due to physical blockage. Aging, diabetes, medications, and inflammatory diseases may impair motility. Diagnostics include imaging, radiopaque markers, and gastrointestinal manometry; scintigraphy can evaluate transit; breath tests may assess certain components.

Treatment and management: Approaches combine dietary modification, hydration, and activity to support motility. Prokinetic medications (for example, prucalopride or metoclopramide) and laxatives or anti-diarrheal agents are used according to the pattern of dysfunction. In severe cases, endoscopic or surgical interventions may be necessary to relieve obstruction or restore function.