Detection of Clustered Gastrointestinal Contractions in Partial Intestinal Obstruction by Surface Vibration Analysis

Abstract

Gastrointestinal contraction "clusters" with alternating quiescence occur in partial intestinal obstruction and are conventionally detected by intraluminal manometry. Surface Vibration Analysis (SVA), which is a noninvasive test, was evaluated in this study in experimental and clinical situations. In the experimental situation, former SVA was assessed against simultaneous manometry in two volunteers, in whom partial obstruction had been induced by intrajejunal balloon distension. Manometry showed typical contraction "clusters" with alternating quiescence, each of two to four minutes duration, in obstructed jejunum proximal to the balloon. The distal jejunum was inhibited. SVA showed a pattern of hyperactivity and quiescence corresponding to proximal jejunal activity. In the clinical situation, SVA recordings taken after a standard meal in nine patients with suspected chronic obstruction adhesive obstruction, (subsequently proven in seven patients and disproved in two), and 36 volunteers were compared. All patients with proved obstruction showed an SVA pattern of alternating hyperactivity and quiescence. This pattern was not observed in volunteers or nonobstructed patients.

Dai-kenchu-to Enhances Accelerated Small Intestinal Movement.

“…For example, in relation to adhesive ileus, it is known that the intestinal motility is different on the proximal side compared with the distal side at the obstruction. 11) Previous and the present results seem to indicate that Dai-kenchu-to has a dual effect on intestinal motility: enhancement in the normal condition; and normalization in the accelerated condition. The effect of Daikenchu-to when intestinal motility was enhanced in the present study, was mainly due to the effects of dried ginger root and ginseng.…”

“…8,10) However, intestinal obstruction following laparotomy is frequently accompanied by abdominal pain, which is thought to be associated with intestinal "cluster" contractions. 11,12) Moreover, cramping abdominal pain is usually noted in IBS, which is characterized by hypercontractility. 13,14) Although the relationship between abnormal gastrointestinal motility and the cause of abdominal pain remains controversial, muscarinic antagonists act as antispasmodics by reducing gastrointestinal hypermotility in patients.…”

Stress and strain analysis of contractions during ramp distension in partially obstructed guinea pig jejunal segments

“…Changes in contraction patterns after partial intestinal obstruction have been reported previously, such as clustered contractions with alternating quiescence (Cullen et al, 1989); increased spontaneous motility and contractile responses to exogenous agents in hypertrophic rat intestinal longitudinal segments (Bertoni et al, 2004), and increased amplitude and frequency of bolus-induced contractility in partial obstructed guinea pig intestine (Storkholm et al, 2008). In patients with chronic intestinal idiopathic pseudo-obstruction, smooth muscle cell contractility induced by acetylcholine was markedly decreased (Guarino et al, 2008).…”

Are Classic Bedside Exam Findings Required to Initiate Enteral Nutrition in Critically Ill Patients: Emphasis on Bowel Sounds and Abdominal Distension

“…In patients presenting to the hospital, auscultation of gastrointestinal sounds was traditionally thought to assist with diagnosing acute gastrointestinal pathologies 38,39 . However, the clinical utility of auscultating the abdomen has been challenged by a number of studies involving healthy volunteers or patients after major surgery 40–44 .…”