Distension-stimulated propagated contractions in human colon

Bassotti, Gabrio; Gaburri, M; Imbimbo, Bruno P.; Morelli, Antonio; Whitehead, William E.

doi:10.1007/bf02088131

Cited by 64 publications

(43 citation statements)

References 25 publications

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“…However, until now no data were available in pathological conditions concerning the other kind of propulsive activity, such as that represented by the LAPC. In healthy subjects, these waves have been described in association with colonic transport of fluids [29, 30], balloon distention of the colon [31], and emission of flatus [32]. This study showed that the LAPC are present and normally distributed in C-IBS patients, and are also significantly increased with respect to STC, suggesting a somewhat alternative propulsive mechanism that might lessen the severity of constipation in these patients.…”

Section: Discussionsupporting

confidence: 39%

Abnormal Colonic Propagated Activity in Patients with Slow Transit Constipation and Constipation-Predominant Irritable Bowel Syndrome

Bassotti

Chistolini²,

Marinozzi³

et al. 2003

Digestion

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Background: The pathophysiological basis of constipation is still unclear, and the role of colonic dysfunction is debated, especially in irritable bowel syndrome. Objective data are quite scarce, especially concerning colonic propulsive activity. Aims: To evaluate high- and low-amplitude colonic propulsive activity in constipated patients (slow-transit type and irritable bowel syndrome) in comparison with normal controls. Patients and Methods: Forty-five constipated patients (35 with slow-transit constipation and 10 with constipation-predominant irritable bowel syndrome) were recruited, and their data compared to those of 18 healthy subjects. Twenty-four-hour colonic manometric recordings were obtained in the three groups of subjects, and data concerning high- and low-amplitude colonic propulsive activity were then compared. Results: High-amplitude propagated contractions were significantly (p < 0.05) decreased in patients with slow-transit constipation and constipation-predominant irritable bowel syndrome with respect to controls (1.5 ± 0.4, 3.7 ± 2, and 6 ± 1 events/subject/day, respectively). In slow-transit constipation, a significant decrease of contractions’ amplitude was also observed. Concerning low-amplitude propagated contractions, patients with slow-transit constipation had significantly less events with respect to patients with constipation-predominant irritable bowel syndrome (46 ± 7 vs. 87.4 ± 19, p = 0.015); no differences were found between patients with slow-transit constipation and controls and between patients with constipation-predominant irritable bowel syndrome and controls. All three groups displayed a significant increase of low-amplitude propagated contractions after meals (6.3 ± 2 vs. 18.2 ± 5 for controls, p < 0.005; 6.4 ± 1.4 vs. 16.3 ± 2.4 for slow-transit constipation, p < 0.005; 10.5 ± 3.2 vs. 32.6 ± 7 for constipation-predominant irritable bowel syndrome, p = 0.001). Conclusions: Low-amplitude propagated contractions may represent an important physiologic motor event in constipated patients, reducing the severity of constipation in patients with irritable bowel syndrome and preserving a residual colonic propulsive activity in patients with slow-transit constipation.

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Section: Discussionsupporting

confidence: 39%

Abnormal Colonic Propagated Activity in Patients with Slow Transit Constipation and Constipation-Predominant Irritable Bowel Syndrome

Bassotti

Chistolini²,

Marinozzi³

et al. 2003

Digestion

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“…The following variables were taken into consideration: (a) contractile response to saline infusion; (b) contractile response to bisacodyl infusion; (c) average onset (minutes) of any response observed; (d) type of contractile response (propagated or nonpropagated waves), wave amplitudes (in mm Hg) were obtainted by subtracting the mean resting colonic pressure (considered as baseline) from the peak of colonic waves [19], and (e) the presence or absence of defecation after bisacodyl infusion. To avoid artifacts due to respiration, only waves of >10 mm Hg amplitude were taken into account for analysis.…”

Section: Methodsmentioning

confidence: 42%

Endoluminal Instillation of Bisacodyl inPatients with Severe (Slow Transit Type)Constipation Is Useful to Test Residual ColonicPropulsive Activity

Bassotti

Chiarioni²,

Germani

et al. 1999

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Background: Chronic constipation is a frequent symptom among the general population, and a minority of cases do not respond to any therapeutic measures, except surgery. The purpose of this study was to test the residual colonic motor propulsive activity with a pharmacologic stimulus in a series of patients referred for severe constipation. Patients: Twenty-five chronically constipated patients, slow transit type, age range 16–71 years, unresponsive to conventional medical treatment and referred for functional evaluation, entered the study. Methods: Colonic manometry by means of an endoscopically positioned probe was carried out in all patients. Following a basal recording period, a placebo solution followed by 10 mg bisacodyl solution was infused into the colon through the more proximal recording port. Results: After bisacodyl infusion, about 90% of patients showed a motor response characterized by the appearance (within on average 13 ± 3 min) of one or more high-amplitude propagated contractions, the manometric equivalent of mass movements, and about 75% of these were followed (mean 18.5 ± 4 min) by defecation. Conclusions: Physiological and pharmacological testing of colonic motor activity may be important in severely constipated patients, especially in those labeled as ‘intractable’, in whom more in depth investigation planning may encourage further therapeutic efforts.

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“…This finding indicates that the increased colonic motor activity induced by bacterial fermentation is not caused by acidification of the colonic contents or the production of SCFAs. 30 Bacterial fermentation may influence intestinal motility through other mechanisms such as the production of gases, since colonic distension is associated with increased HAPCs, 31 and/or other fermentation byproducts such as alcohols, ketones and aldehydes. As aforementioned, intestinal transit can be accelerated by probiotics, however, some other probiotics have been shown to decrease bowel movements, and improve loose stool/diarrhea in patient with diarrhea predominant-irritable bowel syndrome.…”

Section: 8mentioning

confidence: 41%

Alteration of Gut Microbiota and Efficacy of Probiotics in Functional Constipation

Choi

Chang

2015

J Neurogastroenterol Motil

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Article: Change of fecal flora and effectiveness of the short-term VSL#3 probiotic treatment in patients with functional constipation Kim SE, Choi CS, Park KS, et al Functional constipation (FC) is a common symptom-based gastrointestinal (GI) disorder without organic abnormality, the prevalence of which is between 5% and 20% of the general population.1,2 The symptoms of constipation can be severe; thus, this disorder has a significant impact on patient's quality of life. 3The cause of FC remains unclear, especially for slow transit constipation. Alterations of the gut microbiota have been suggested as one possible pathophysiologic mechanism of FC. 4,5 However, the quantitative and/or qualitative changes of the gut microbiota in FC are poorly understood, and many discrepancies exist in the literature.In the current issue of the Journal of Neurogastroenterology and Motility, Kim et al 6 have published a prospective study in which they investigated the characteristics of gut microbiota in patients with FC using quantitative real-time polymerase chain reaction. The authors found that Bifidobacterium and Bacteroides species were significantly less abundant in feces from patients with FC compared with healthy controls. However, no significant differences were observed regarding the proportion of Lactobacillus, Escherichia coli and Clostridium species. These results are partially consistent with previous studies that have analyzed the fecal microbiota in patients with FC. 7,8Bifidobacterium and Lactobacillus have been shown to be significantly less abundant in adult patients with constipation. 8 One study found that patients with constipation predominant-irritable bowel syndrome exhibited significantly less lactate-producing (bifidobacteria and lactobacilli) and lactate-utilizing bacteria in their feces compared with controls; moreover, the abundances of H 2 -consuming populations, methanogens and reductive acetogens were also significantly lower in these patients compared with controls. 7 In contrast, a study of children with constipation found that the levels of bifidobacteria and clostridia were increased in

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Distension-stimulated propagated contractions in human colon

Cited by 64 publications

References 25 publications

Abnormal Colonic Propagated Activity in Patients with Slow Transit Constipation and Constipation-Predominant Irritable Bowel Syndrome

Abnormal Colonic Propagated Activity in Patients with Slow Transit Constipation and Constipation-Predominant Irritable Bowel Syndrome

Endoluminal Instillation of Bisacodyl inPatients with Severe (Slow Transit Type)Constipation Is Useful to Test Residual ColonicPropulsive Activity

Alteration of Gut Microbiota and Efficacy of Probiotics in Functional Constipation

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