Our hypothesis was that manometry in the colon was less sensitive than the electronic barostat in detection of colonic contractions. In ten healthy volunteers, we have characterised the pressure activity and tone of the colon by means of combined multilumen manometry and a barostatic balloon that was infinitely compliant, conformed to the colon's inner wall, and was clamped at a constant ‘operating’ pressure throughout the study. A computer program separated indices of the colon's motor function detected by the barostat: a baseline volume and phasic volume events. The barostat detects on average 70% more phasic pressure events than manometric sideholes located 2 em proximal to 7 cm distal to the balloon. Manometry becomes less sensitive than the barostat when the colonic diameter exceeds 5.6 em. The barostat detects on average 90% of all propagated and non-propagated (>30 mmHg) manometric peaks. The baseline volume changes significantly after the ingestion of a 1000-kcal meal, consistent with an increment in colonic tone, undetected by manometry. A combined barostat—manometry assembly appears to be preferable to manometry alone in the intraluminal evaluation of human colonic pressure activity and tone.
To identify patterns of motility in the rectum of humans during the day while awake and at night during sleep, and to correlate the patterns with interdigestive duodenal motor complexes and sleep cycles, intraluminal rectal pressure was recorded in 12 healthy subjects (five female, seven male; mean age, 28 years) using a flexible, noncompliant, silastic catheter and an Arndorfer system with a single perfused rectal port 6 cm above the anorectal junction, duodenal motility was recorded via a perf...
Abstract Background/Aims: Carcinoid patients show a hypertonic colonie motor response postprandially. Ondansetron reduces postprandial colonie tone in health. It was hypothesized that ondansetron, a selective 5HT 3 antagonist, corrects the colonic motor response to eating in carcinoid diarrhea. Methods: The effects of ondansetron and placebo on fasting and postprandial colonic tone and motility in 10 patients with carcinoid diarrhea were compared using a manometry-barostat assembly positioned in...
This study examined the hypothesis that 5HT3 mechanisms mediate the postprandial gastrocolonic response in humans. Fasting and postprandial colonic tone and motility were studied in 12 healthy volunteers and the effects of a selective 5HT3 antagonist, ondansetron assessed in a double blind, randomised, placebo controlled fashion. A manometry barostat assembly was positioned in the transverse or descending colon to quantitate contractile activity fasting, after drug infusion and postprandially af...
Background and Methods The pathophysiology of diarrhea in patients with the carcinoid syndrome is not understood. Possible causes include tumor production of neurohumoral substances, such as serotonin and substance P, which stimulate small-bowel and colonic motility, and intestinal abnormalities, such as lymphangiectasia and bacterial overgrowth. We undertook this study to determine whether carcinoid diarrhea is associated with abnormal motor function in the small intestine and colon. We measure...
The motor function of the colon is probably the least understood of the various hollow viscera of the human body. This is partly because of the marked variability of colonic motor function and the short recording periods usually used, generally not exceeding three hours. Most of the data available on human colonic motility originate from investigations conducted in the most distal portions of the viscus, because of technical difficulties in reaching its proximal portions. Although attempts have ...
The colonic motor effects of fractionated irradiation were studied in five conscious dogs. Seven colonic and two ileal strain gauge transducers were implanted. After control recordings, an abdominal dose of 250 cGy was administered three times a week on alternate days for three successive weeks (total dose 2,250 cGy). Recordings were then continued for 3 wk after the completion of radiation. Colonic giant migrating contractions (GMCs) occurred at a frequency of 0.15 +/- 0.05 contractions/h in th...
In this study, our aim was to test the hypothesis that colonic tone is abnormal in patients with irritable bowel syndrome (IBS). We studied eight patients with IBS and eight age-matched asymptomatic control subjects, in whom tone and motility were measured by an electronic barostat and by pneumohydraulic perfusion manometry, respectively. Tone and motility were recorded from the descending colon for a 14-hour period—3 hours awake, 7 hours asleep, 2 hours fasting after awakening, and 2 hours post...
We evaluated colon manometry as a means of differentiating causes of intractable constipation in children. We studied pressure changes in the transverse, descending, and rectosigmoid colons of 23 children with intractable constipation. All patients had a history of less than one bowel movement per week for longer than 2 years without resolution after conventional medical management. The possibility of Hirschsprung disease was excluded in all. On the basis of pathologic and manometric studies of ...
Abstract The inherent variability of symptoms and motor abnormalities in patients with the irritable bowel syndrome has hampered the demonstration of motor abnormalities that could underlie symptoms. The aim in the current study was to evaluate whether altered regional capacitance or transit of solid residue through the unprepared human gut were factors in the diarrhea of patients with the irritable bowel syndrome. In 10 such patients and in 5 healthy controls, gastric and small bowel transits w...
Abstract Preprandial and postprandial colonic motility and transit (scintigraphy), with respect to the splenic flexure, were studied in 10 patients with ulcerative colitis and in 9 healthy subjects. The healthy subjects had a postprandial increase in intraluminal pressure that was significantly ( P P
Gut microbiota may affect function of the dorsolateral prefrontal cortex (DLPFC). However, there has been no study on modification of brain-gut interactions with repetitive transcranial magnetic stimulation (rTMS) to the DLPFC. We hypothesized that stimulation of the right or left DPFC by rTMS modifies the brain-gut interactions in humans. Subjects were 25 healthy males. Viscerosensory evoked potential (VEP) with sham (0 mA) or actual (30 mA) electrical stimulation (ES) of the rectum was taken a...
Motility of the large bowel may be grossly subdivided in two types of contractile activity: low-amplitude single or cyclic propagated waves and high-amplitude propagated activity. The latter is mainly apt to shift relatively large amounts of colonic contents, and it is related to defecation. The main component of this propagated activity is represented by the radiologically-identified mass movements, that have a manometric equivalent known as high-amplitude propagated contractions (HAPC). The pr...
Last. Jan Tack(Boston Children's Hospital)H-Index: 126
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Alterations in colonic motility are implicated in the pathophysiology of bowel disorders, but high-resolution manometry of human colonic motor function has revealed that our knowledge of normal motor patterns is limited. Furthermore, various terminologies and definitions have been used to describe colonic motor patterns in children, adults and animals. An example is the distinction between the high-amplitude propagating contractions in humans and giant contractions in animals. Harmonized termino...
BACKGROUND: In recent years, high-resolution manometry has been used in an attempt to gain a greater insight into the physiology/pathophysiology of colonic contractile activity in healthy adults and patients with colonic motility disorders. New colonic motor patterns have been identified and characterized, however, the clinical significance of these findings remains undetermined. PURPOSE: This review will assess the current literature on colonic high-resolution manometry and determine if this pr...
The uses and limitations of the various techniques of video spatiotemporal mapping based on change in diameter (D-type ST maps), change in longitudinal strain rate (L-type ST maps), change in area strain rate (A-type ST maps) and change in luminous intensity of reflected light (I-maps) are described, along with their use in quantifying motility of the wall of hollow structures of smooth muscle such as the gut. Hence ST-methods for determining the size, speed of propagation and frequency of contr...
Abstract The human colon serves to absorb water and electrolytes, store intraluminal contents until elimination is socially convenient, and salvage nutrients after bacterial metabolism of carbohydrates that have not been absorbed in the small intestine. These functions are dependent on the colon's ability to control the distal progression of contents; in healthy adults, colonic transit normally requires several hours to almost 3 days for completion. There are differences in colonic structure and...
Colonic motility consists of a range of motor patterns that ensure net flow rates appropriate for the break down of food, absorption of water and nutrients and excretion of waste. Abnormalities in these motor patterns remain a leading hypothesis to explain the cause of functional colonic disorders such as constipation. However, whilst manometric catheters are used as one of the primary tools to record colonic motor patterns, we are as yet unable to define motor patterns that clearly separate pat...
This is the accepted version of the following article: [Arkwright, J. W., Dickson, A., Maunder, S. A., Blenman, N. G., Lim, J., O’Grady, G., Archer, R., Costa, M., Spencer, N. J., Brookes, S., Pullan, A. and Dinning, P. G. (2013), The effect of luminal content and rate of occlusion on the interpretation of colonic manometry. Neurogastroenterology & Motility, 25: e52–e59.], which has been published in final form at [http://dx.doi.org/10.1111/nmo.12051]. In addition, authors may also transmit, pri...