EDITORIAL COMMENT The right side of the colon tends to be relatively inaccessible to study. These observations, made by the telemetering technique of recording pressure, increase our knowledge of this region and show that activity on the right side of the colon tends to be independent of the activity in the sigmoid colon and rectum.There are many reported studies of sigmoid and rectal motility, but less is known about the motility of the proximal colon, especially in the intact human. In this study intraluminal pressures in the proximal colon were recorded with an ingestible radio-telemetering capsule (Rowlands and Wolff, 1960; Connell, McCall, Misiewicz, and Rowlands, 1963) and compared with simultaneous pressure records from tubes introduced into the left colon. Patients with and without colonic disorders were studied in the basal state, after a meal and following parenteral prostigmine.
PATIENTS STUDIED AND TECHNIQUETwenty-two patients were studied, brief clinical details being shown in Table I. Cases I to 1, with no symptoms referable to the colon, had a normal bowel habit and no abdominal pain at the time of the study; they were all in good general health. Cases 12 to 16 had the spastic colon syndrome, but were symptomless at the time of the study. Six other patients (nos. 17 to 22) had non-specific diarrhoea with or without left-sided abdominal pain and in all of these, symptoms were present at the time of study. All the diarrhoeal patients had a normal barium enema and faecal fat output and in none were pathogens found in the stools.The radio-telemetering capsule was swallowed on the evening before the study together with a small quantity of barium; the following morning the capsule was localized by screening with an image amplifier. Additional information of value in localization came from the pressure record itself and from the estimation of the point of maximum signal strength in relation to the anterior abdominal wall. Intraluminal pressures from the left colon were recorded with 4 x 7 mm. air-filled rubber balloons, placed through a sigmoidoscope at 10 and 20 cm. 'Present address:
PURPOSE: This study was designed to investigate colonic spike bursts regarding 1) their migration behavior, 2) their pressure correlates, and 3) comparing colonic short spike bursts with spike bursts from migrating myoelectric complex from the small bowel. METHODS: Rectosigmoid electromyography and manometry were recorded simultaneously in seven normal volunteers and electromyography alone in five others during two hours of fasting and for two hours after one 2,100-kJ meal. One patient with an ileostomy was also studied by the same method to record the migrating myoelectric complex from the terminal ileum during fasting. RESULTS: Three kinds of spike bursts were observed in the pelvic colon: rhythmic short spike bursts, migrating long spike bursts, and nonmigrating long spike bursts. The meal significantly increased the number of migrating and nomnigrating long spike bursts (from 25 to 38.7 percent of the recording time; P < 0.01). These bursts of potentials showed a peak 15 minutes after the meal, which may be caused by the gastrocolic reflex. Migrating long spike bursts started anywhere along the rectosigmoid and migrated from there aborad 82 percent of the time and orad or in both directions in 10 or 7 percent of the time, respectively. They originated pressure waves 99 percent of the time. Short spike bursts were more frequent before the meal (15.1 percent before and 9.6 percent after the meal), but the difference was not significant; they neither propagated nor initiated pressure waves detected by the miniballoon. CONCLUSIONS: Migrating long spike bursts were the only potentials that migrated, sometimes for short distances. Short spike bursts are a different phenomenon from the small-bowel migrating myoelectric complex because they do not migrate; they can occur during the postprandial period and never originated intraluminal pressure waves.
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