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- Title
High-resolution colonic motility recordings in vivo compared with ex vivo recordings after colectomy, in patients with slow transit constipation.
- Authors
Dinning, P. G.; Sia, T. C.; Kumar, R.; Mohd Rosli, R.; Kyloh, M.; Wattchow, D. A.; Wiklendt, L.; Brookes, S. J. H.; Costa, M.; Spencer, N. J.
- Abstract
Background The pathogenesis of slow transit constipation ( STC) remains poorly understood, with intrinsic and extrinsic abnormalities implicated. Here, we present high-resolution colonic manometry recordings from four STC patients recorded before total colectomy, and subsequently, ex vivo, after excision. Methods In four female, treatment-resistant STC patients (median age 35.5 years), a fiber-optic manometry catheter (72 sensors spaced at 1 cm intervals) was placed with the aid of a colonoscope, to the mid-transverse colon. Colonic manometry was recorded 2 h before and after a meal. After the colectomy, ex vivo colonic manometry was recorded in an organ bath. Ex vivo recordings were also made from colons from 4 patients (2 male; median age 67.5 years) undergoing anterior resection for nonobstructive carcinoma ('control' tissue). Key Results A large increase in 'short single propagating contractions' was recorded in STC colon ex vivo compared to in vivo ( ex vivo 61.3 ± 32.7 vs in vivo 2.5 ± 5/h). In STC patients, in vivo, the dominant frequency of contractile activity was 2-3 cycle per minute (cpm), whereas 1-cpm short-single propagating contractions dominated ex vivo. This same 1-cpm frequency was also dominant in control colons ex vivo. Conclusions & Inferences In comparison to control adults, the colon of STC patients demonstrates significantly less propagating motor activity. However, once the STC colon is excised from the body it demonstrates a regular and similar frequency of propagating activity to control tissue. This paper provides interesting insights into the control of colonic motor patterns.
- Subjects
GASTROINTESTINAL motility disorders; COLECTOMY; CONSTIPATION; MANOMETERS; HIGH resolution imaging
- Publication
Neurogastroenterology & Motility, 2016, Vol 28, Issue 12, p1824
- ISSN
1350-1925
- Publication type
Article
- DOI
10.1111/nmo.12884