Changes in colonic myoelectric spiking activity during stimulation by bisacodyl

Abstract

The purpose of this study was to determine some relationships between colonic myoelectric spiking activity and intraluminal propulsion when colonic peristalsis was stimulated by bisacodyl. Myoelectric recordings were obtained in 12 subjects by means of a 50 cm long Silastic tube equipped with four bipolar electrodes fixed at 10-cm intervals. The tube was introduced into the left colon by flexible sigmoidoscopy and the electrodes were located at 50, 40, 30, and 20 cm from the anal verge. A small polyethylene catheter opening at the proximal end of the Silastic tube was used for introducing the laxative into the colon. One hour recording sessions were obtained before and after bisacodyl administration (5 mL of 0.4% solution). The control tracings showed that colonic spiking activity was made of rhythmic stationary bursts that occurred at only one electrode site and of sporadic bursts that were either propagating over the whole colonic segment or nonpropagating. Administration of bisacodyl was followed by complete suppression of the rhythmic stationary activity; a considerable increase in the sporadic spiking activity, propagating as well as nonpropagating; the occurrence of abdominal cramps and urgency to defecate, both associated with the propagating sporadic spike bursts. It is concluded that colonic propulsion induced by bisacodyl may be dependent upon the production of the sporadic bursts, particularly the propagating ones, while the rhythmic stationary bursts do not seem to play a significant role in colonic transit.

Internal anal sphincter relaxation associated with bisacodyl‐induced colonic high amplitude propagating contractions in children with constipation: a colo‐anal reflex?

“… 2 However, in previous studies, it has been shown that the administration of bisacodyl is a good marker of neuro‐enteric integrity and it has been used to induce HAPC’s and shorten study duration 17 . Although the exact mechanism of action of bisacodyl has not been fully elucidated, bisacodyl has been reported to increase myoelectrical propagating activity, 18 transit in the ascending colon 19 and rectal tone 20 in humans. It has also been shown to decrease expression of aquaporin‐3 resulting in inhibition of water passage from lumen to vascular space in rats, producing diarrhea 21 .…”

Review article: colonic sensorimotor physiology in health, and its alteration in constipation and diarrhoeal disorders

“…Assessment of colonic contractility appears worthwhile in patients with slow transit constipation who are being considered for colectomy. In such patients, the preservation of the colon’s response to feeding, 86 cholinergic agonists, 134 or intraluminal bisacodyl 100 , 135 excludes inertia, and argues against pursuing a subtotal colectomy and in favour of conservative measures, including use of motility stimulating agents or pelvic floor retraining.…”

Bowel-cleansing methods affecting PET-CT image interpretation

“…This agent is available with or without a prescription. Bisacodyl is a contact laxative, which acts on the large intestine to produce strong but brief peristaltic movements [10]. It influences intestinal fluid transport and augments epithelial permeability [11].…”