3 Ways to Fix Small Intestinal Gut Motility
Small intestinal gut motility refers to the movement of the small intestine, specifically the proper functioning of the migrating motor complex (MMC). The MMC is a crucial system of nerves and muscles that ensures food moves efficiently from the small intestine to the large intestine. (1) Impaired MMC function can increase the risk of small intestinal bacterial overgrowth (SIBO) and intestinal methanogen overgrowth. Below are three effective strategies to improve small intestinal motility and support gut health.
1. Intermittent Fasting and Avoiding Snacking
The MMC operates only during fasting periods. Once you consume food, the MMC pauses its sweeping action in the small intestine. To allow the MMC to function effectively, fasting for certain periods is essential.(1)
Intermittent Fasting
Intermittent fasting involves alternating periods of eating and fasting. During the eating window, you consume all your daily meals, while the fasting window is dedicated to refraining from food. Typical regimens include:
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6/18: Eat for 6 hours, fast for 18 hours.
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8/16: Eat for 8 hours, fast for 16 hours.
To maintain the fasting state, avoid consuming anything with calories, including artificial sweeteners, as they can trigger an insulin response that halts MMC activity. Safe beverages during fasting include black coffee, unsweetened tea, and water. While pure fats like MCT oil may not technically break a fast, it's best to avoid them if your goal is to enhance gut motility.
Snacking
Frequent snacking throughout the day disrupts the MMC, preventing it from cleaning the small intestine effectively. Limiting food intake to structured meals without snacking can significantly improve gut motility.
Disclaimer: Intermittent fasting may not be suitable for everyone. Consult with your doctor before starting an intermittent fasting regimen.
2. Prokinetic Supplements or Medications
Prokinetics, derived from the word "kinetic" (movement), enhance gut motility by activating specific receptors in the body. Unlike laxatives, prokinetics target the small intestine and support MMC function (2), even in non-constipated individuals.
Prescription Prokinetics
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Prucalopride (Motegrity): A commonly recommended option.
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Low-dose naltrexone: Used off-label for gut motility.
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Erythromycin: An antibiotic prescribed in low doses for this purpose.
Over-the-Counter Prokinetics
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Ginger
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5-HTP
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Artichoke extract
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Herbal blends containing various supportive ingredients
Each prokinetic works differently based on the receptors it activates. Consult with a healthcare provider to determine the best option for your needs.
3. Ileocecal Valve Massage
The ileocecal valve separates the small intestine from the large intestine, allowing contents to move in one direction. If the valve malfunctions and remains open, bacteria from the large intestine can travel backward into the small intestine, increasing the risk of SIBO.(3,4)
Technique for Ileocecal Valve Massage
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Locate the valve: It is situated about halfway between your belly button and the top of your right hip bone, slightly closer to the hip.
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Apply pressure: Using your index and middle fingers, press firmly on the area.
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Massage: Move your fingers in a clockwise motion for about 30 seconds. Variations include pressing inward and toward the belly button or right shoulder.
You may hear gurgling sounds during the massage, which can indicate the valve is open. Regular practice can help restore proper valve function and support gut motility.
Summary
To enhance small intestinal gut motility and reduce the risk of SIBO or intestinal methanogen overgrowth, consider these strategies:
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Practice intermittent fasting and avoid snacking.
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Use prokinetic supplements or medications under medical guidance.
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Perform ileocecal valve massage to improve valve function.
By implementing these techniques, you can support your digestive health and promote a well-functioning gut. If you found this information helpful, share it with others who might benefit!
Citations:
1. Takahashi T. Interdigestive migrating motor complex -its mechanism and clinical importance. J Smooth Muscle Res. 2013;49:99-111. doi:10.1540/jsmr.49.99
2. Nightingale JMD, Paine P, McLaughlin J, et al. The management of adult patients with severe chronic small intestinal dysmotility. Gut. 2020;69(12):2074-2092. doi:10.1136/gutjnl-2020-321631
3. Chander Roland B, Mullin GE, Passi M, et al. A Prospective Evaluation of Ileocecal Valve Dysfunction and Intestinal Motility Derangements in Small Intestinal Bacterial Overgrowth. Dig Dis Sci. 2017;62(12):3525-3535. doi:10.1007/s10620-017-4726-4
4. Miller LS, Vegesna AK, Sampath AM, Prabhu S, Kotapati SK, Makipour K. Ileocecal valve dysfunction in small intestinal bacterial overgrowth: a pilot study. World J Gastroenterol. 2012;18(46):6801-6808. doi:10.3748/wjg.v18.i46.6801