Colonic mass movements in idiopathic chronic constipation.

Bassotti, Gabrio; Gaburri, M; Imbimbo, Bruno P.; Rossi, Lisa; Farroni, F; Pelli, Maria Antonietta; Morelli, Antonio

doi:10.1136/gut.29.9.1173

Cited by 230 publications

(157 citation statements)

References 25 publications

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“…Karaus and Sarna suggested that the absence of GMCs results in poor propulsion, lead ing to constipation, while too frequent occurrence of GMCs results in rapid propulsion and diarrhea (1). After wards, this notion was substantiated clinically in patients with idiopathic chronic constipation (15) or functional di arrhea (2), in which decrease or increase in the number of GMCs was observed, respectively. Thus, suppression of the occurrence of GMCs by clonidine may in part account for its anti-diarrheal activity.…”

mentioning

confidence: 79%

Colonic Giant Migrating Contractions Induced by Glycerol Enema in Anesthetized Rats

Tomaru

Ishii

Kishibayashi

et al. 1993

Japanese Journal of Pharmacology

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ABSTRACT-Colonic motility was measured with three catheter pressure transducers that were inserted into the descending colon at the distance of 4 cm, 6 cm and 8 cm from the anal verge in anesthetized rats. Colonic infusion of glycerol (65%, 2 ml/kg) induced large phasic pressure changes with high amplitude and long duration. Some of the pressure changes propagated over all the three recording sites, appearing to be equivalent to giant migrating contractions. These glycerol-induced large propulsions were abolished by lido caine (5%, 2 ml/kg, intracolon), hexamethonium (10 mg/kg, i.v.) or clonidine (30 pg/kg, i.v.); and they were almost entirely suppressed by atropine (3 mg/kg, i.v.), suggesting the principal involvement of the cholinergic neural pathway.

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mentioning

confidence: 79%

Colonic Giant Migrating Contractions Induced by Glycerol Enema in Anesthetized Rats

Tomaru

Ishii

Kishibayashi

et al. 1993

Japanese Journal of Pharmacology

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“…30 Similar studies in slow transit constipation patients have found a reduced daily frequency of high amplitude propagating sequences (also recognised as mass movements and responsible for a significant proportion of propulsive activity in the colon), and that all high amplitude propagating sequences originate in the proximal colon. 29,31,32 It is therefore plausible that the prolonged colonic transit times during oxycodone treatment in this study share-at least partly-pathophysiological characteristics with slow transit constipation, and that further development of the 3D-Transit software could elucidate this neglected, yet important aspect of GI motility. Along the same line, the increased transit in the rectosigmoid colon during oxycodone treatment could indicate that not only transit, but possibly also defecation, is affected.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Opioid Treatment on Regional Gastrointestinal Transit

Poulsen

Nilsson

Brock

et al. 2016

J Neurogastroenterol Motil

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Background/AimsTo employ an experimental model of opioid-induced bowel dysfunction in healthy human volunteers, and evaluate the impact of opioid treatment compared to placebo on gastrointestinal (GI) symptoms and motility assessed by questionnaires and regional GI transit times using the 3-dimensional (3D)-Transit system. MethodsTwenty-five healthy males were randomly assigned to oxycodone or placebo for 5 days in a double blind, crossover design. Adverse GI effects were measured with the bowel function index, gastrointestinal symptom rating scale, patient assessment of constipation symptom questionnaire, and Bristol stool form scale. Regional GI transit times were determined using the 3D-Transit system, and segmental transit times in the colon were determined using a custom Matlab ® graphical user interface. ResultsGI symptom scores increased significantly across all applied GI questionnaires during opioid treatment. Oxycodone increased median total GI transit time from 22.2 to 43.9 hours (P < 0.001), segmental transit times in the cecum and ascending colon from 5.7 to 9.9 hours (P = 0.012), rectosigmoid colon transit from 2.7 to 9.0 hours (P = 0.044), and colorectal transit time from 18.6 to 38.6 hours (P = 0.001). No associations between questionnaire scores and segmental transit times were detected. ConclusionsSelf-assessed GI adverse effects and increased GI transit times in different segments were induced during oxycodone treatment. This detailed information about segmental changes in motility has great potential for future interventional head-to-head trials of different laxative regimes for prevention and treatment of constipation.

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“…48 It is characterized by reduced high-amplitude propagated contractions 49,50 in the colon, leading to slow transit of feces, bloating, abdominal discomfort, and infrequent defecation. 51 The protracted time in the colon also renders the feces hard and small and fails to mount sufficient rectal pressure to trigger the defecation reflex.…”

Section: Intrinsic Factorsmentioning

confidence: 99%

Chronic Constipation: An Evidence-Based Review

Leung¹,

Riutta²,

Kotecha³

et al. 2011

The Journal of the American Board of Family Medicine

272

168

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Background: Chronic constipation is a common condition seen in family practice among the elderly and women. There is no consensus regarding its exact definition, and it may be interpreted differently by physicians and patients. Physicians prescribe various treatments, and patients often adopt different over-the-counter remedies. Chronic constipation is either caused by slow colonic transit or pelvic floor dysfunction, and treatment differs accordingly.Methods: To update our knowledge of chronic constipation and its etiology and best-evidence treatment, information was synthesized from articles published in PubMed, EMBASE, and Cochrane Database of Systematic Reviews. Levels of evidence and recommendations were made according to the Strength of Recommendation taxonomy.Results

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Colonic mass movements in idiopathic chronic constipation.

Cited by 230 publications

References 25 publications

Colonic Giant Migrating Contractions Induced by Glycerol Enema in Anesthetized Rats

Colonic Giant Migrating Contractions Induced by Glycerol Enema in Anesthetized Rats

The Impact of Opioid Treatment on Regional Gastrointestinal Transit

Chronic Constipation: An Evidence-Based Review

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