Speculations on the role of motility in the pathogenesis and treatment of diarrhoea.

Comparatively little attention has been given to the role of gastrointestinal motility in the pathogenesis and treatment of diarrhoea. Here the relationship between motor activity and absorption in the small intestine has been assessed, as has that between small intestinal secretion and motility, and between colonic salvage and motility. It is suggested that diarrhoea should be considered as a disturbance of intestinal flow, involving disturbances in both motility and transport. The role of antimotility agents (particularly opiate-like agents such as loperamide) is reviewed. The most successful antidiarrhoeal agents are those that combine a reversal of epithelial secretion with an action on motility.