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Characterization of Simultaneous Pressure Waves as Biomarkers for Colonic Motility Assessed by High-Resolution Colonic Manometry
- Source :
- Frontiers in Physiology, Frontiers in Physiology, Vol 9 (2018)
- Publication Year :
- 2018
-
Abstract
- Simultaneous pressure waves (SPWs) in manometry recordings of the human colon have been associated with gas expulsion. Our hypothesis was that the SPW might be a critical component of most colonic motor functions, and hence might act as a biomarker for healthy colon motility. To that end, we performed high-resolution colonic manometry (HRCM), for the first time using an 84-sensor (1 cm spaced) water-perfused catheter, in 17 healthy volunteers. Intraluminal pressure patterns were recorded during baseline, proximal and rectal balloon distention, after a meal and following proximal and rectal luminal bisacodyl administration. Quantification was performed using software, based on Image J, developed during this study. Gas expulsion was always associated with SPWs, furthermore, SPWs were associated with water or balloon expulsion. SPWs were prominently emerging at the termination of proximal high amplitude propagating pressure waves (HAPWs); we termed this motor pattern HAPW-SPWs; hence, SPWs were often not a pan-colonic event. SPWs and HAPW-SPWs were observed at baseline with SPW amplitudes of 12.0 ± 8.5 mmHg and 20.2 ± 7.2 mmHg respectively. The SPW occurrence and amplitude significantly increased in response to meal, balloon distention and luminal bisacodyl, associated with 50.3% anal sphincter relaxation at baseline, which significantly increased to 59.0% after a meal, and 69.1% after bisacodyl. Often, full relaxation was achieved. The SPWs associated with gas expulsion had a significantly higher amplitude compared to SPWs without gas expulsion. SPWs could be seen to consist of clusters of high frequency pressure waves, likely associated with a cluster of fast propagating, circular muscle contractions. SPWs were occasionally observed in a highly rhythmic pattern at 1.8 ± 1.2 cycles/min. Unlike HAPWs, the SPWs did not obliterate haustral boundaries thereby explaining how gas can be expelled while solid content can remain restrained by the haustral boundaries. In conclusion, the SPW may become a biomarker for normal gas transit, the gastrocolonic reflex and extrinsic neural reflexes. The SPW assessment reveals coordination of activities in the colon, rectum and anal sphincters. SPWs may become of diagnostic value in patients with colonic dysmotility.
- Subjects :
- 0301 basic medicine
medicine.medical_specialty
Physiology
Rectum
Balloon
lcsh:Physiology
03 medical and health sciences
0302 clinical medicine
colonic motility
Physiology (medical)
Internal medicine
medicine
Bisacodyl
High resolution manometry
Original Research
lcsh:QP1-981
business.industry
simultaneous pressure waves
gastro-colonic reflex
high-amplitude propagating pressure wave
030104 developmental biology
medicine.anatomical_structure
high-resolution manometry
bisacodyl
Cardiology
Reflex
Biomarker (medicine)
030211 gastroenterology & hepatology
Rectal Balloon
business
anal sphincter pressure
Colonic motility
medicine.drug
Subjects
Details
- ISSN :
- 1664042X
- Volume :
- 9
- Database :
- OpenAIRE
- Journal :
- Frontiers in physiology
- Accession number :
- edsair.doi.dedup.....cc11166d2e01bc9cf0d679d7288d3189