Gastrocolonic Response

Dorfman, Lev; El‐Chammas, Khalil; Mansi, Sherief; Kaul, Ajay

doi:10.1007/s11894-022-00849-2

Cited by 6 publications

(5 citation statements)

References 77 publications

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“…Out a total of 297 colonic manometries performed during the study period, 89 fulfilled the inclusion criteria. Females constituted 47% of the cohort with a median age of 9 years (IQR of 5,12). Most of the studies (85.4%) included were high resolution colonic manometry studies.…”

Section: Re Sultsmentioning

confidence: 99%

“…This physiologic response is used as a marker of an intact neuromuscular interaction between the central and enteric nerval system (ENS) in colonic manometry studies 5 …”

Section: Introductionmentioning

confidence: 99%

“…4 This physiologic response is used as a marker of an intact neuromuscular interaction between the central and enteric nerval system (ENS) in colonic manometry studies. 5 The exact stimuli and pathway of the GCR remain unclear. The vagus nerve was shown to have a stimulatory effect on the GCR.…”

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confidence: 99%

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Novel sensory trigger for gastrocolonic response

Dorfman

Wongteerasut

El‐Chammas

et al. 2023

Neurogastroenterology Motil

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The gastrocolonic response (GCR), often referred to as gastrocolonic reflex, describes a physiologic increase in motor activity of the colon following meal ingestion, which was first described by Cannon in 1902, with the term GCR being proposed by Hertz a few years later. 1,2 The increase in colonic motor activity from baseline maybe subtle or more pronounced, mostly in younger children, resulting in high amplitude propagated contractions (HAPC). 3 The response propagates fecal content and gas throughout the colon and allows new intestinal content to enter the colon. It is typically noted within minutes after meal ingestion. 4 This physiologic response is used as a marker of an intact neuromuscular interaction between the central and enteric nerval system (ENS) in colonic manometry studies. 5 The exact stimuli and pathway of the GCR remain unclear. The vagus nerve was shown to have a stimulatory effect on the GCR. 6 The GCR is evoked by gastric distention and by lipid infusion into the

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Section: Re Sultsmentioning

confidence: 99%

“…This physiologic response is used as a marker of an intact neuromuscular interaction between the central and enteric nerval system (ENS) in colonic manometry studies 5 …”

Section: Introductionmentioning

confidence: 99%

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Novel sensory trigger for gastrocolonic response

Dorfman

Wongteerasut

El‐Chammas

et al. 2023

Neurogastroenterology Motil

Self Cite

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“…High‐amplitude propagating contractions (HAPCs) were defined as propagating contractions with pressures of at least 60 mm Hg, lasting 10 s and propagating for at least 30 cm 14 . Colonic inertia was defined as the complete absence of HAPCs throughout the colon, hyperactive colon was defined as having more than 0.11 HAPCs per minute in the fasting or postprandial phases, and absent gastrocolonic response was defined as a postprandial increase in motility index <15% from fasting baseline 15–17 . A CM study was considered normal if HAPCs were noted in the baseline fasting or fed phases or after stimulation with bisacodyl in all segments of the colon, and there was a normal gastrocolonic response.…”

Section: Methodsmentioning

confidence: 99%

Diagnostic yield of left‐sided colonic manometry in identifying colonic dysmotility in pediatric patients

Dorfman,

El‐Chammas,

Brijawi

et al. 2024

Neurogastroenterology Motil

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BackgroundColonic manometry (CM) is a diagnostic procedure utilized in the evaluation of intractable constipation and involves endoscopic insertion of a manometry catheter with the tip placed in the cecum. Difficulty in advancing the colonic manometry catheter to the right colon and/or distal displacement of the catheter after appropriate placement can result in partial evaluation of the colon. Our study aimed to assess the value of limited left CM in identifying motility disorders.MethodsWe evaluated CM studies conducted at a tertiary pediatric center (2019–2022). Abnormal CM studies with catheter tips located in the cecum or ascending colon were included.Key ResultsOf 161 CM studied, 68 with abnormal CM studies met inclusion criteria (29 [42.7%] females, median age 10.3 years). Pan‐colonic dysmotility was noted in 29 (42.7%) studies and segmental dysmotility in 39 (57.4%) studies. Dysmotility of the descending and/or sigmoid colon was the most common segmental dysmotility (30, 76.9%). Isolated dysmotility of the ascending colon was noted only in patients with a cecostomy (6/13, 46.2%). The diagnostic sensitivity for dysmotility by left CM was 91.2%, which increased to 100% when excluding patients with cecostomy.Conclusions and InferencesLeft CM is a valuable and sensitive diagnostic tool for identifying abnormal colonic motility in most pediatric patients with constipation without cecostomy. Our study results provide reassurance when the manometry catheter becomes dislodged from the cecum and moves distally. Those with cecostomy have a high prevalence of dysmotility in the ascending colon and need a complete CM to identify it.

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“…This suggests daily rhythms in defecation is not acutely sensitive to lighting conditions and thus likely represents an endogenous circadian rhythm. Yet, daily feeding rhythms show circadian rhythmicity and food intake potently stimulates gut motility, including defecation ( Dorfman et al, 2022 ). Thus it remains possible that defecation patterns are not intrinsically circadian but is triggered by processes that are, such as feeding.…”

Section: Introductionmentioning

confidence: 99%

Circadian rhythms in colonic function

Hibberd,

Ramsay,

Spencer-Merris

et al. 2023

Front. Physiol.

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A rhythmic expression of clock genes occurs within the cells of multiple organs and tissues throughout the body, termed “peripheral clocks.” Peripheral clocks are subject to entrainment by a multitude of factors, many of which are directly or indirectly controlled by the light-entrainable clock located in the suprachiasmatic nucleus of the hypothalamus. Peripheral clocks occur in the gastrointestinal tract, notably the epithelia whose functions include regulation of absorption, permeability, and secretion of hormones; and in the myenteric plexus, which is the intrinsic neural network principally responsible for the coordination of muscular activity in the gut. This review focuses on the physiological circadian variation of major colonic functions and their entraining mechanisms, including colonic motility, absorption, hormone secretion, permeability, and pain signalling. Pathophysiological states such as irritable bowel syndrome and ulcerative colitis and their interactions with circadian rhythmicity are also described. Finally, the classic circadian hormone melatonin is discussed, which is expressed in the gut in greater quantities than the pineal gland, and whose exogenous use has been of therapeutic interest in treating colonic pathophysiological states, including those exacerbated by chronic circadian disruption.

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Gastrocolonic Response

Cited by 6 publications

References 77 publications

Novel sensory trigger for gastrocolonic response

Novel sensory trigger for gastrocolonic response

Diagnostic yield of left‐sided colonic manometry in identifying colonic dysmotility in pediatric patients

Circadian rhythms in colonic function

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