Quantification of in vivo colonic motor patterns in healthy humans before and after a meal revealed by high‐resolution fiber‐optic manometry

Abstract

Background Until recently, investigations of the normal patterns of motility of the healthy human colon have been limited by the resolution of in vivo recording techniques. Methods We have used a new, high-resolution fiber-optic manometry system (72 sensors at 1-cm intervals) to record motor activity from colon in 10 healthy human subjects. Key Results In the fasted colon, on the basis of rate and extent of propagation, four types of propagating motor pattern could be identified: (i) cyclic motor patterns (at 2–6/min); (ii) short single motor patterns; (iii) long single motor patterns; and (iv) occasional retrograde, slow motor patterns. For the most part, the cyclic and short single motor patterns propagated in a retrograde direction. Following a 700 kCal meal, a fifth motor pattern appeared; high-amplitude propagating sequences (HAPS) and there was large increase in retrograde cyclic motor patterns (5.6±5.4/2 h vs 34.7±19.8/2 h; p < 0.001). The duration and amplitude of individual pressure events were significantly correlated. Discriminant and multivariate analysis of duration, gradient, and amplitude of the pressure events that made up propagating motor patterns distinguished clearly two types of pressure events: those belonging to HAPS and those belonging to all other propagating motor patterns. Conclusions & Inferences This work provides the first comprehensive description of colonic motor patterns recorded by high-resolution manometry and demonstrates an abundance of retrograde propagating motor patterns. The propagating motor patterns appear to be generated by two independent sources, potentially indicating their neurogenic or myogenic origin.

The impact of opioid treatment on regional gastrointestinal transit

“…30 Similar studies in slow transit constipation patients have found a reduced daily frequency of high amplitude propagating sequences (also recognised as mass movements and responsible for a significant proportion of propulsive activity in the colon), and that all high amplitude propagating sequences originate in the proximal colon. 29,31,32 It is therefore plausible that the prolonged colonic transit times during oxycodone treatment in this study share-at least partly-pathophysiological characteristics with slow transit constipation, and that further development of the 3D-Transit software could elucidate this neglected, yet important aspect of GI motility. Along the same line, the increased transit in the rectosigmoid colon during oxycodone treatment could indicate that not only transit, but possibly also defecation, is affected.…”

“…20 An alternative, but invasive, method to examine colonic motility patterns is high-resolution fiber-optic manometry. 29 A recent study employing this technique in slow transit constipation patients found that the normal increase in the postprandial propagating cyclic motor pattern was absent in patients when compared to healthy controls. 30 Similar studies in slow transit constipation patients have found a reduced daily frequency of high amplitude propagating sequences (also recognised as mass movements and responsible for a significant proportion of propulsive activity in the colon), and that all high amplitude propagating sequences originate in the proximal colon.…”

The Enteric Nervous System

“…At one 1 cm spacing the retrograde motor patterns are by far the most prominent motor pattern identifi ed (Dinning et al , 2014. At one 1 cm spacing the retrograde motor patterns are by far the most prominent motor pattern identifi ed (Dinning et al , 2014.…”

“…Quantifi cation of motor patterns recorded with these catheters in the healthy colon is only just beginning, however applying discriminant, logistic and cluster analysis of the shapes (gradient, duration, amplitude) of pressure events belonging to different motor patterns suggests that the motor appear to be generated by two independent sources, potentially indicating their neurogenic or myogenic origin (Dinning et al 2014 ). The clinical worth and the potential diagnostic value of such recordings in patient groups is still to be determined.…”

A composite fibre optic catheter for monitoring peristaltic transit of an intra-luminal bead

“…A more recent development has been ’high resolution manometry’ (HRM) in which large numbers of pressure sensors are placed along the length of a catheter to record activity at ˜10 mm intervals along the gut . Optical fibre sensing arrays have been adapted for HRM recordings by a number of groups due to their inherent advantages of high flexibility, small dimensions, and the ability to multiplex many discrete sensing regions along a single fibre . HRM recordings reveal detailed intraluminal pressure profiles that have dramatically improved the ability of manometric studies to define both the normal and abnormal contractile patterns of the gut.…”