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Health Information The Body in Motion

Just as cars can break down and cause traffic jams on a busy freeway, health problems can interrupt, slow or stop the body's internal motions. And in the body, as on the road, getting things to flow smoothly again in the following systems isn't always easy.

The nervous system
The vascular system
The gastrointestinal tract

The nervous system: Lost signals

From solving math problems to moving your fingers and toes, the brain controls many of the body's functions. But when the pathways for brain-to-body messages are damaged, the movement of nerve signals between the brain and the body can slow down or even stop.

In the disease multiple sclerosis (MS), the body's immune system attacks the coating around the nerves, called myelin, impeding the smooth transmission of messages.

Such slow messages within the brain and spinal cord result in blurred vision, muscle weakness, difficulties with coordination, trouble thinking and a number of other symptoms.

"The immune system protects us against bacteria, viruses and other problems, but an abnormally overactive immune system can damage the body's own parts," says Dusan Stefoski, MD, a neurologist at Rush University Medical Center.

With time, more damage to the central nervous system occurs, resulting in multiple areas where nerve signals are slowed or completely blocked.

About six years ago, Rush became among the first in the world to offer a therapy called immune ablation for MS that can slow or even stop the condition for up to several years. High-dose chemotherapy is used to destroy the faulty immune system. A drug is then given to help build a new immune system that will not do the damage MS causes it to do.

Rush has also led the way in MS research with a promising new drug called fampridine, which is currently being reviewed by the U.S. Food and Drug Administration. "This drug can enable the damaged nerves to get the impulses through once again, thus improving various functions in people with MS," Stefoski says.

Dusan Stefoski, MD, offers leading-edge treatments for multiple sclerosis, including medications to treat spasticity and special testing using transcranial magnetic stimulation. He is also director of the
Multiple Sclerosis Center at Rush.

The vascular system: Blocked blood flow

The vascular system's normal movement of oxygenated blood from the heart to all other organs and tissues in the body can slow, and eventually even halt, in places because of a disease called atherosclerosis. This disease, in turn, clogs the inner lining of the arteries with a buildup of plaque (fatty deposits and other substances, including cholesterol and calcium), causing the blood flow to slow.

Chest pain may be the first indication the heart isn't getting enough oxygen, but by then the artery is at least 70 percent clogged, according to Jeffrey Snell, MD, an interventional cardiologist at Rush. A complete blockage means no blood can move through the artery, causing tissue death due to lack of oxygen — also known as a heart attack.

A similar thing happens when the blood flow to the brain is disrupted because of atherosclerosis in the carotid arteries, which supply the brain with oxygen-rich blood. When blood is unable to move through the arteries to reach an area of the brain, oxygen starvation occurs — resulting in a stroke.

 

Treatments that can get blood moving normally again have improved significantly over the years. Medications called statins slow the process of atherosclerosis by lowering cholesterol and slowing the formation of plaque. Blood thinners help prevent blood clots that cause blockage. Angioplasty, a procedure used to open blocked arteries, is also very successful and can be used nearly any-where in the body to restore blood flow.

Rush is testing two ways to grow new blood vessels in the body that create alternate routes for blood to move around blocked arteries: injecting genes into the heart muscle or legs directly and using a patient's own stem cells or another adult's stem cells.

Jeffrey Snell, MD, performs special procedures, including carotid artery stent placement and endovascular repair of abdominal aortic aneurysms. He is currently studying stem cells to grow new blood vessels in patients with poor circulation.

The gastrointestinal tract: Digestion and movement

As anyone who has ever experienced constipation can confirm, problems along the gastrointestinal tract can stop or slow the movement of what we eat and drink in uncomfortable ways. But when issues such as constipation become an ongoing problem, it may mean part of the digestive system isn't working properly.

Two common problems with movement of the gastrointestinal system and transit of its contents, called motility disorders, may be the culprits: colonic inertia and pelvic floor dysfunction.

Colonic inertia. When food and fluid move through the digestive tract, they are propelled by peristalsis, a muscle action that resembles an ocean wave in the muscle walls. The muscles contract and narrow, and then the narrowed portion is propelled forward, pushing food and fluid ahead of it.

"With colonic inertia the bowel is healthy, but the muscle contracts slowly so it has trouble moving stool through the colon," says Keith Bruninga, MD, a gastroenterologist at Rush who specializes in motility disorders. By the time the stool makes its way toward the rectum, it is difficult to pass.

Two kinds of laxatives are prescribed to treat this problem: osmotic and stimulant. Osmotic laxatives draw fluid into the intestinal tract, making the stool soft so it can move through the colon more easily. Stimulant laxatives work by causing contractions of the smooth muscle of the colon to help push the stool along.

Pelvic floor dysfunction. When you have a bowel movement, the abdominal wall muscles contract and the pelvic floor muscles relax to push out the stool. With pelvic floor dysfunction, the stool moves normally through the colon, but as it gets to the pelvis and the rectal area, the muscles of the pelvis don't relax.

"When the pelvic floor muscles do not relax, the patient experiences a relatively closed system," Bruninga says. "This may cause patients to feel like they have more stool that needs to come out, which can lead them to strain their muscles."

Both disorders are seen mostly in women, and the causes are unknown. Whatever the cause, constipation can make a person feel bloated and sluggish. It can also cause complications, such as hemorrhoids and anal fissures (tears around the anus that can cause rectal bleeding).

Fortunately, help is available. For example, a specially trained physical therapist can help someone with pelvic floor dysfunction learn to properly use the abdominal and pelvic floor muscles when trying to have a bowel movement.

Keith Bruninga, MD, is board certified in internal medicine and gastroenterology. His areas of interest include colonic motility and functional gastro-intestinal disorders.

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