During the last week of 2014, my oldest daughter, A, spent three days in the hospital for slow motility issues. Before A’s recent bouts of stomach issues, I would have been hitting up Google for what “slow motility” might mean in terms of the gut, but after the hospital trip I mentioned in the last post I have been thinking about it a lot.
Slow motility is not a blockage in the gut (constipation). Rather, it is a great slowing down of the digestive track, a slowing of movement down the track and a slowing of absorption of nutrients. So with a slowing of the body’s ability to move food down the track being the culprit, I began to wonder why I never hear of MS patients with slow motility. MS impeding our nerve signals seems to slow every other part of our body’s ability to respond to stimuli.
With that question in mind, I went to patientslikeme.com where Bowel problems are listed as the sixth most common symptom of MS, but included under that symptom umbrella are “any difficulty in passing feces including constipation, bowel incontinence (loss of bowel control), and diarrhea.” Motility issues are not mentioned, but I note my daughter has had all of those symptoms resulting from her motility issues. A quick search for “motility” on the site netted nothing. So I asked the board how many MS patients have motility issues. The only 2 patients who identified as having motility issues had them predate their MS. I would also point out many MS patients are on drugs for other MS symptoms which can cause bowel problems, and thus not all bowel problems experienced by MS patients are the result of MS.
If one assumes the common theory of MS these days, the disease is one where our immune system is attacking our nervous system. These attacks destroy our nerve’s myelin sheath and eventually its ability to transmit signals. There are numerous studies about the slowing, sometimes to a stop, of parts of the nervous system in MS patients. There are also numerous studies showing the majority of a healthy immune system resides in our gut-associated lymphoid tissue (GALT). http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2515351/
If our immune system is what is attacking our nervous system, why do we have comparatively little damage to the nervous system closest to the largest concentration of cells in our immune system? This is the question which has been itching me for a week. I have posted the question to the MSresearch blog out Cambridge England, and one of their researchers said he would have to look to find me the answer.
I have a few theories which would/could explain the issue.
1) Measurement error: On patientslikeme.com, bowel problems were reported but not motility issues. I am not sure most people with bowel problems get motility studies to assess the cause/ true nature of the problem, and I bet this goes double with MS patients. My experience is the difficult to explain or prove is often assumed to be the result of MS without ever questioning how MS caused the problem. So many of these bowel issues could be motility related, and we would not know.
2) It is possible the 70% of our immune system is not the part of our immune system attacking our nervous system. If this is the case, we have effectively eliminated 2/3 of our immune system as a potential cause of our MS.
3) There is something in the gut weeding off or neutralizing the cells responsible for triggering an attack on the nervous system in our gut. If this is the case, is this cause replicable outside our gut?
I am sure there are more possibilities, but I was never a very good biology student. I just find myself trying to attack the MS problem from another angle. Too often, we respond to what we see in MS with regards to symptoms and progression. It’s natural to have our attention focused on what we can observe and better yet, measure.
If the measure of the power of science is its ability to predict, then it follows science often draws its power from what we observe. The trick is to recognize when we fail to see what we expect to see. For even such failures represent an observation. It is with that recognition that we can start looking for the cause of failure in our expectations/hypothesis. Perhaps, the answer is already obvious to those who have studied our immune system and our gut. I just rarely see mentioned anywhere in our nervous system immune to the effects of MS.
Maybe we should look where the symptoms fail to appear in an effort to better explain where and how they do.