Gut Motility and Enteric Nervous System Dysfunction in Endo

You may remember me talking about a study showing 80% of participants with endometriosis also had SIBO.

If you're thinking, "I thought you said it was 90%," that's a more recent study.

So the one that I'm talking about now is older.

But what many people don't know about this study, and what I think doesn't get talked about enough and hasn't been kind of researched any further, I feel, as, as far as I know, no one has looked into this, is that this study also found 100% of the participants had a dysfunction of their small intestine motility.

To understand what this means, let's first do a recap of the migrating motor complex.

So the migrating motor complex is a wavelike motion that cleans the small intestine of food, debris, and bacteria.

It kicks in two hours after we eat and overnight, but it is not the same as the motility that causes a bowel movement.

That happens in the large intestine.

The migrating motor complex happens in the small intestine.

Now, the migrating motor complex can become damaged or slowed, or there may be something structurally wrong with the intestines that is disrupting the MMC, which is what we call the migrating motor complex for short.

This disruption, this damage, this slowing down of the MMC is the root cause of SIBO.

Something is either structurally wrong or functionally wrong with the migrating motor complex.

This damage can be, and is usually, caused by food poisoning or gastroenteritis.

But in endometriosis patients, we also have other risk factors that can affect the health of our MMC, from adhesions sticking to our intestines to co-conditions that alter motility, like Ehlers-Danlos syndrome.

But there's also an intriguing behavior seen in our intestines which seems unique to us endo patients.

When studying SIBO rates of endometriosis patients, researchers found that parts of the small intestine were spasming, leading to altered digestion.

This spasming was caused by enteric nervous system dysfunction, which is a part of our nervous system that governs digestion and is largely regulated by the vagus nerve, which is this massive nerve that runs from the base of your neck, from, like, from your brain down to the base of your spine.

And the researchers noticed that the pattern was almost like a seizure of the enteric nervous system, and it was firing off nerve signals and creating these spasms.

And I'm going to link the paper in the show notes, and if you go to the paper, you'll see the pictures, um, showing what the spasms look like, and you can kind of see the difference, like, in a person who's not having the spasming and a person with, and it literally looks like, on paper, it looks like a seizure.

Like, it, it looks, the way that the graph has drawn this pattern, it's very, very clear However, and here's what's so interesting, this wasn't a dysfunction of the MMC itself.

It was happening mostly during the night, which is when the MMC is the most active.

It did happen to some degree very early in the morning as well, um, but it was entirely independent of the MMC.

So the migrating motor complex was still working, it was still doing its thing, and the small intestine was spasming.

The researchers believe that this spasm was caused by hyperinsulin secretion.

So as a reminder, insulin is the hormone that controls blood sugar levels, and it increases when your blood sugar levels are high or when we have become insulin resistant.