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

Bassotti, Gabrio; Chiarioni, Giuseppe; Germani, Ugo; Battaglia, Edda; Vantini, Italo; Morelli, Antonio

doi:10.1159/000007591

Cited by 63 publications

(51 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The possibility of recording colonic motor activity for prolonged periods of time (24 h or more) in the whole colon [27,28], and that of assessing visceral perception and compliance in the rectum and rectosigmoid area [29] have recently added further to our understanding of the pathophysiological basis of CDD.…”

Section: Colonic Motor and Sensory Activity In Cddmentioning

confidence: 99%

Colonic Diverticular Disease: Abnormalities of Neuromuscular Function

Bassotti

Villanacci²

2012

Dig Dis

Self Cite

View full text Add to dashboard Cite

Although diverticular disease of the colon (diverticulosis) is a frequent finding in Western countries, its pathophysiologic grounds are still only partially understood. Traditionally considered as an age-related condition, colonic diverticulosis is probably the final result of several factors concurring together to determine the anatomo-functional abnormalities eventually causing outpouching of the viscus’ mucosa. Among these factors, a relevant role seems to be played by an abnormal neuromuscular function of the large bowel, as shown by abnormal myoelectrical and motor function repeatedly described in these patients, as well as by altered visceral perception. These anomalies might be related to the recent demonstration of derangement of enteric innervation (especially involving interstitial cells of Cajal and enteric glial cells), mucosal neuropeptides, and mucosal inflammation. The latter may have a role of paramount importance in the development of visceral hypersensitivity, responsible for abdominal pain in a subset of patients.

show abstract

Section: Colonic Motor and Sensory Activity In Cddmentioning

confidence: 99%

Colonic Diverticular Disease: Abnormalities of Neuromuscular Function

Bassotti

Villanacci²

2012

Dig Dis

Self Cite

View full text Add to dashboard Cite

show abstract

“…Concerning STC, some data suggest an impairment of colonic propulsive activity, represented by a reduced daily number of high-amplitude propagated contractions (HAPC), the manometric equivalent of mass movements [11, 12, 13, 14, 15]; more recently, similar data have been described in constipation-predominant IBS (C-IBS) patients [16]. However, impairment of HAPC is probably not sufficient to explain the overall derangement of colonic transport.…”

Section: Introductionmentioning

confidence: 98%

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

Bassotti

Chistolini²,

Marinozzi³

et al. 2003

Digestion

Self Cite

View full text Add to dashboard Cite

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.

show abstract

“…All in all, the available literature and those provided in the study suggest that since relamorelin might be considered as a relatively pure ''pusher,'' at least in the colon, this drug may be effective in the treatment of constipation, even though its propulsive effects seem to be relatively feeble when compared with those characteristic of other drugs [5][6][7][8]. Nevertheless, its ability to stimulate proximal gut motility [11] combined with its subcutaneous route of administration might benefit not only conventional constipated subjects, but also other subtypes of constipation such as in post-operative and neutrally compromised patients, and in patients refractory to all other medications [13].…”

mentioning

confidence: 83%

“…Therefore, since drugs can increase the frequency and amplitude of colonic contractions, especially the manometric equivalents of mass movements, termed high-amplitude propagated contractions [4], such medications could prove useful tools in constipation treatment. To date, objective documentation in humans of such stimulation is available for only a few clinically available drugs, including bisacodyl [5], macrogol [6], chenodeoxycholic acid [7], and prucalopride [8].…”

mentioning

confidence: 99%