Definition

Increased peristaltic motions of the intestines in such a way that they become visible through the abdominal walls.

Etiology And Symptomatology

While in the normal state intestinal peristalsis is accomplished without being visible or making itself felt, in pathological conditions increased peristalsis may exist which can be easily perceived through the abdominal walls and which is usually accompanied by distinct noises (borborygmi). Increased intestinal peristalsis may accompany any complete or incomplete occlusion of the intestinal lumen or it may be caused by purely neurotic influences. Here only the latter form is dealt with, as the former condition is discussed in connection with the organic lesions causing it.

1 Wallace: St. Barthol. Hosp. Report, 1888.

Usually peristaltic restlessness of the intestines occurs in the form of attacks, lasting several hours in succession and reappearing after more or less long periods of time. In some instances the patients complain of various movements and noises within the abdomen due to the increased intestinal peristalsis, while pain is absent. In other instances the above sensations are now and then interspersed with severe colicky pains. The majority of cases of peristaltic restlessness of the intestines is accompanied rather by constipation, seldom there are either normal evacuations or diarrhoea. In some instances the exaggerated peristaltic motions continue even after intestinal digestion has been completed, and are accompanied by painful sensations. Peristaltic restlessness of the intestines is occasionally associated with peristaltic restlessness of the stomach.

Peristaltic restlessness of the intestines is principally met with in nervous persons, in the hysterical and hypochondriacal. Occasionally, however, it occurs in persons who do not present any other nervous symptoms. In women this condition may exist during the monthly periods or pregnancy. In some persons it appears after the ingestion of highly spiced or indigestible foods, after the excessive use of tobacco, after great psychical excitement or too much brain work. In other cases, however, none of these etiological factors can be discovered.

Diagnosis

The diagnosis of peristaltic restlessness of the intestines is made whenever pronounced intestinal motions are visible through the abdomen. The nervous character of this condition is recognized, first, after exclusion of organic affections of the intestines; secondly, by its periodic appearance.

The prognosis is favorable.

Treatment

In the first place it is of importance to invigorate the entire organism and especially improve the condition of the nervous system. With regard to diet sufficient quantities of food should be given, but too spicy and indigestible nourishment should be excluded. In cases accompanied by some abnormality of the bowels their function should be regulated. The bromides, valerian, and asafetida are of decided value. Drinking of warm water or tea and hot applications are useful during the attack. Arsenic alone or in combination with iron is of benefit in cases combined with anaemia. If the condition assumes a violent character and is accompanied by severe pains, a small dose of an opiate, alone or in combination with belladonna, is appropriate. If the intestinal restlessness appears at night time and prevents the patient from sleeping, chloral hydrate, sulphonal, or trional may be administered. Electricity and massage of the abdomen have been variously recommended, but neither of the two appears to me to be of great value in this condition.

Change of climate and surroundings is often of benefit.