Classification of normal and abnormal colonic motility based on cross‐correlations of pancolonic manometry data

Wiklendt, Lukasz; Mohammed, Sahar; Scott, S. M.; Dinning, Phil G.

doi:10.1111/nmo.12077

Cited by 11 publications

(8 citation statements)

References 35 publications

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“…Simultaneous pressure waves were more or less ignored for a long time because pan-colonic pressure changes can be caused by general abdominal pressure increases and in some studies such events were deliberately filtered out ( Wiklendt et al, 2013 ). Indeed, abdominal pressure changes, due to coughing, straining or changing of body position, will give simultaneous pressure changes, but these activities are usually associated with external sphincter contraction, not with anal sphincter relaxation ( Chen et al, 2017 ) and they are associated with abdominal muscular action potentials whereas SPWs are not ( Corsetti et al, 2017 ).…”

Section: Discussionmentioning

confidence: 99%

Characterization of Simultaneous Pressure Waves as Biomarkers for Colonic Motility Assessed by High-Resolution Colonic Manometry

et al. 2018

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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.

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Section: Discussionmentioning

confidence: 99%

Characterization of Simultaneous Pressure Waves as Biomarkers for Colonic Motility Assessed by High-Resolution Colonic Manometry

et al. 2018

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“…In each manometric recording, obvious artifacts of simultaneous pressure events that spanned all recording channels were digitally removed as previously described …”

Section: Methodsmentioning

confidence: 99%

“…In each manometric recording, obvious artifacts of simultaneous pressure events that spanned all recording channels were digitally removed as previously described. 27 The manometric traces consist of a variety of 'pressure events' (individual phasic pressure excursions recorded by a sensor). Two categories of rapid small amplitude pressure events were commonly identified.…”

Section: Analysis Of Manometric Datamentioning

confidence: 99%

Quantification of in vivo colonic motor patterns in healthy humans before and after a meal revealed by high‐resolution fiber‐optic manometry

Dinning

Wiklendt

Maslen

et al. 2014

Neurogastroenterology Motil

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338

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Background Until recently, investigations of the normal patterns of motility of the healthy human colon have been limited by the resolution of in vivo recording techniques. Methods We have used a new, high-resolution fiber-optic manometry system (72 sensors at 1-cm intervals) to record motor activity from colon in 10 healthy human subjects. Key Results In the fasted colon, on the basis of rate and extent of propagation, four types of propagating motor pattern could be identified: (i) cyclic motor patterns (at 2–6/min); (ii) short single motor patterns; (iii) long single motor patterns; and (iv) occasional retrograde, slow motor patterns. For the most part, the cyclic and short single motor patterns propagated in a retrograde direction. Following a 700 kCal meal, a fifth motor pattern appeared; high-amplitude propagating sequences (HAPS) and there was large increase in retrograde cyclic motor patterns (5.6±5.4/2 h vs 34.7±19.8/2 h; p < 0.001). The duration and amplitude of individual pressure events were significantly correlated. Discriminant and multivariate analysis of duration, gradient, and amplitude of the pressure events that made up propagating motor patterns distinguished clearly two types of pressure events: those belonging to HAPS and those belonging to all other propagating motor patterns. Conclusions & Inferences This work provides the first comprehensive description of colonic motor patterns recorded by high-resolution manometry and demonstrates an abundance of retrograde propagating motor patterns. The propagating motor patterns appear to be generated by two independent sources, potentially indicating their neurogenic or myogenic origin.

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“…A segment immediately prior to bisacodyl administration was used given the number of motor patterns present in response to bisacodyl. These segments were analyzed using ImageJ where baseline corrections were made as outlined previously, a Gaussian filter was used with width of the Gaussian defined as 60 seconds. Upon determining the average pressure ± SD of the 5‐minutes intervals during baseline and immediately prior to bisacodyl administration in each volunteer, a non‐parametric Wilcoxon signed‐rank test was conducted, given the limited sample size, to assess whether there was a difference in basal intraluminal pressures.…”

Section: Methodsmentioning

confidence: 99%

The cyclic motor patterns in the human colon

Pervez

Ratcliffe

Parsons

et al. 2020

Neurogastroenterology Motil

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are co-senior authors.Abbreviations: CMP, Cyclic motor pattern; HAPW, High-amplitude propagating pressure wave; SPW, Simultaneous pressure wave. AbstractBackground: High-resolution colonic manometry gives an unprecedented window into motor patterns of the human colon. Our objective was to characterize motor activities throughout the entire colon that possessed persistent rhythmicity and spanning at least 5 cm.Methods: High-resolution colonic manometry using an 84-channel water-perfused catheter was performed in 19 healthy volunteers. Rhythmic activity was assessed during baseline, proximal balloon distention, meal, and bisacodyl administration.Key Results: Throughout the entire colon, a cyclic motor pattern occurred either in isolation or following a high-amplitude propagating pressure wave (HAPW), consisting of clusters of pressure waves at a frequency centered on 11-13 cycles/min, unrelated to breathing. The cluster duration was 1-6 minutes; the pressure waves traveled for 8-27 cm, lasting 5-8 seconds. The clusters itself could be rhythmic at 0.5-2 cpm.The propagation direction of the individual pressure waves was mixed with >50% occurring simultaneous. This high-frequency cyclic motor pattern co-existed with the well-known low-frequency cyclic motor pattern centered on 3-4 cpm. In the rectum, the low-frequency cyclic motor pattern dominated, propagating predominantly in retrograde direction. Proximal balloon distention, a meal and bisacodyl administration induced HAPWs followed by cyclic motor patterns. Conclusions and Inferences:Within cyclic motor patterns, retrograde propagating, low-frequency pressure waves dominate in the rectum, likely keeping the rectum empty; and mixed propagation, high-frequency pressure waves dominate in the colon, likely promoting absorption and storage, hence contributing to continence.Propagation and frequency characteristics are likely determined by network properties of the interstitial cells of Cajal. K E Y W O R D S colonic motility, cyclic motor pattern, high-resolution colonic manometry, interstitial cells of Cajal, rectal pressure waves S U PP O RTI N G I N FO R M ATI O N Additional supporting information may be found online in the Supporting Information section.

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Classification of normal and abnormal colonic motility based on cross‐correlations of pancolonic manometry data

Cited by 11 publications

References 35 publications

Characterization of Simultaneous Pressure Waves as Biomarkers for Colonic Motility Assessed by High-Resolution Colonic Manometry

Characterization of Simultaneous Pressure Waves as Biomarkers for Colonic Motility Assessed by High-Resolution Colonic Manometry

Quantification of in vivo colonic motor patterns in healthy humans before and after a meal revealed by high‐resolution fiber‐optic manometry

The cyclic motor patterns in the human colon

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