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In order to better understand the rectosigmoid motor activity in diverticular disease of the colon, we studied 186 patients, grouped according to their intestinal habit, the presence of diverticular disease and previous crisis of sigmoid diverticulitis. The intestinal habit was classified as: normal habit, irritable colon syndrome, diarrhea and constipation. The group of diverticulosis was classified by their intestinal habit and by diverticula localization (localized or generalized). The presence of systemic diseases or drug ingestion that could modify intestinal motility, were considered criteria for exclusion. The manometric study was preceded by food stimulus, with 650 kcal meal, by mechanic intestinal cleansing, with 500 ml of saline solution enema and by one hour resting period. A manometric catheter, was introduced by rectosigmoidoscopy, with open ended orifices situated at the sigmoid and upper rectum, respectively. The catheter was perfused by a capillary infusion system and the bowel pressures were registered for 30 minutes, in a thermal paper physiograph. We analyzed the % of activity, mean amplitude and motility index, by non parametric tests. No significant difference was observed between sexes. Difference or close to it were found for the groups with constipation, with or without diverticulosis, and for the latter in its subdivisions (localized, generalized and sigmoid diverticulitis). The rectal motor activity was similar in all groups. There was no difference for diverticulosis and its subdivision, when we take into account the several kinds of intestinal habits and the diverticula localization. The motility index averages showed low values for the sigmoid diverticulitis fact that suggests some dysfunction of this segment (hypocontractility). The key factor differentiating the groups was the presence of constipation and no influence was noted regarding the localization of diverticula or previous inflammatory process on intraluminal pressures. The fact that no difference was found in the mean amplitude or % of activity among patients with or without diverticulosis, suggests that the high pressures in a colonic segment, may not be responsible for the diverticular disease, and there must be other factors, besides motility, accounting for the development of the different forms of this disease.

The basal motility of the sigmoid colon and rectum was evaluated manometrically over 3 consecutive 10-minute periods in 29 control subjects, 14 chagasic patients without megacolon, and 32 chagasic patients with megacolon. The results indicated that the sigmoid colon of both chagasic groups had a lower motility index and lower wave frequency than that of the controls. Reduced wave frequency was observed in the rectum of patients with megacolon, out the rectum of the chagasic patients without megacolon showed manometric characteristics similar to those for the controls. The abnormalities observed were attributed to intramural denervation of the viscera under study. Waves of long duration were observed very frequently in megacolon, and were assumed to be caused by dilatation in itself and not by abnormal contraction of muscle fibers.

This study included ten subjects with normal intestinal habits and 25 with constipation. Data were collected from X-rays of gastrointestinal transit times and from intraluminal pressures in the sigmoid and rectum using electromanometry. A comparison of the results led to the following conclusions: a) transit times to the cecum were essentially similar in both the control group and patients with constipation; b) the barium contrast arrived faster in the proximal sigmoid of patients with constipation compared to the control group; c) the mean of the total time of gastrointestinal emptying was slower in constipation; d) under unstimulated conditions, the electromanometry study of the sigmoid and rectum showed a higher motility index in constipation than in the control group; e) the high values of the percent activity was the most important element in the elevation of the motility index in constipation; f) the propulsion and retention activities of the colon were higher in constipation than in normals, as was demonstrated by radiologic and electromanometric studies.