Multiple-Balloon-Kymograph Recording of Intestinal Motility in Man With Observations on the Correlation of the Tracing Patterns With Barium Movements 1

Abstract

The balloon water manometer system has long been employed in animals and in man as a means of recording graphically the motility of the alimentary tract (1, 2). As others have done, we have used this method to study the behavior of adjacent segments of the small intestine in man under control conditions and in response to drugs and placebos (3, 4). The purpose of this communication is to describe the recording procedure and the evaluation of the tracing patterns. The results of the drug and placebo studies are to be reported elsewhere.Certain drawbacks to the use of the balloon water manometer system have been presented by Quigley (5). He has pointed out that this method necessitates using a large volume/pressure coefficient which does not maintain a linear relationship. The pressure, moreover, registered by the balloon varies depending on its changing shape and on the degree of patency of the intestinal lumen. These objections did not primarily concern us as we were interested in qualitative and relative quantitative changes in motility rather than in absolute measurements of intraluminal pressures.Various workers have described graphic records of motility in terms of their non-propulsive and propulsive character (6-9). Adler, Atkinson and Ivy (6) observed that in the colon of patients with colostomies low, relatively rapid wave patterns were non-propulsive while high, sustained contractions were associated with the forward movement of the intestinal contents provided adequate coordination existed between bowel segments. Abbott and Pendergrass (7) felt that a

Endoradiosonde study of propulsion and pressure activity induced by test meals, Prostigmine, and diphenoxylate in the small intestine

“…The possibility of a connexion between the type lII waves and propulsion has received much attention. Some investigators using balloon and x-ray techniques have found a synchronism between the propulsion of the intestinal content and the occurrence of a type III wave (Chapman and Palazzo, 1949;Glazebrook, 1956). With the endoradiosonde technique we have not been able to confirm this view.…”

Gastric, Duodenal and Jejunal Motility in Man; Physiological Studies by Balloon‐kymography

“…Their duration is 20-60 seconds, tending to the shorter period. They are due to peristaltic contractions and represent the passage of a single wave over the balloon (Chapman et al, 1949). They correspond with the "hunger contractions" of Carlson (1916) rig.…”