Restoration of normal colonic motor patterns and meal responses after distal colorectal resection

Vather, Ryash; O’Grady, Gregory; Arkwright, John W.; Rowbotham, DS; Cheng, Leo K.; Dinning, Phil G.; Bissett, Ian P.

doi:10.1002/bjs.10074

Cited by 28 publications

(35 citation statements)

References 40 publications

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“…The distal colon plays an important role in defaecation control and continence preservation through its retrograde cyclic pattern of contraction 25 . Manometric studies suggest that this pattern may act as a braking mechanism as it appears on arrival of stool from the proximal colon 26 -28 . When the sigmoid colon is resected, bowel function might be substantially altered.…”

Section: Discussionmentioning

confidence: 99%

Bowel dysfunction after sigmoid resection for cancer and its impact on quality of life

Elfeki

Larsen

Emmertsen

et al. 2018

British Journal of Surgery

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Section: Discussionmentioning

confidence: 99%

Bowel dysfunction after sigmoid resection for cancer and its impact on quality of life

Elfeki

Larsen

Emmertsen

et al. 2018

British Journal of Surgery

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“…Analytical methods for HR colonic manometry have been published in full elsewhere. The primary analysis was performed in PlotHRM (Flinders University, Adelaide, South Australia, Australia).…”

Section: Methodsmentioning

confidence: 99%

Hyperactive cyclic motor activity in the distal colon after colonic surgery as defined by high-resolution colonic manometry

Vather

O’Grady

Lin

et al. 2018

British Journal of Surgery

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104

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“…Similar to healthy controls, there was a significant and appropriate increase in retrograde cyclic motor patterns in response to a meal. 107 With the use of HR manometry, there is now the opportunity to perform indepth investigations of the motor patterns that may be contributory to low anterior resection syndrome.…”

Section: Low Anterior Resection Syndromementioning

confidence: 99%

The “rectosigmoid brake”: Review of an emerging neuromodulation target for colorectal functional disorders

Lin

Dinning

Milne

et al. 2017

Clin Exp Pharma Physio

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SummaryThe regulation of gastrointestinal motility encompasses several overlapping mechanisms including highly regulated and coordinated neurohormonal circuits. Various feedback mechanisms or "brakes" have been proposed. While duodenal, jejunal, and ileal brakes are well described, a putative distal colonic brake is less well defined.Despite the high prevalence of colonic motility disorders, there is little knowledge of colonic motility owing to difficulties with organ access and technical difficulties in recording detailed motor patterns along its entire length. The motility of the colon is not under voluntary control. A wide range of motor patterns is seen, with long intervals of intestinal quiescence between them. In addition, the use of traditional manometric catheters to record contractile activity of the colon has been limited by the low number of widely spaced sensors, which has resulted in the misinterpretation of colonic motor patterns. The recent advent of high-resolution (HR) manometry is revolutionising the understanding of gastrointestinal motor patterns. It has now been observed that the most common motor patterns in the colon are repetitive two to six cycles per minute (cpm) propagating events in the distal colon. These motor patterns are prominent soon after a meal, originate most frequently in the rectosigmoid region, and travel in the retrograde direction. The distal prominence and the origin of these motor patterns raise the possibility of them serving as a braking mechanism, or the "rectosigmoid brake," to limit rectal filling. This review aims to describe what is known about the "rectosigmoid brake," including its physiological and clinical significance and potential therapeutic applications. K E Y W O R D Scolon, gastrointestinal motility, gastrointestinal tract, high-resolution manometry, rectosigmoid brake | INTRODUCTIONColonic motility disorders are prevalent in the general population and can have a significant impact on quality of life.1-3 Gastrointestinal transit and the act of defaecation require a coordinated interplay between intrinsic neurohormonal circuits acting on a morphologically intact gastrointestinal tract. These are highly auto-regulated and coordinated events, optimised for ideal transit, maximum absorption, and timely elimination of waste products.Networks of gastrointestinal "brakes" have long been proposed to provide negative feedback controls on gastrointestinal motility. 4-12Duodenal and jejunal brakes are recognised responses to the arrival of nutrient-dense chyme into the upper small intestine, triggering neurohormonal circuits that impart feedback control on gastric emptying, gastric distention and satiety. 6,8 Distally, the ileal brake is capable of a potent inhibition of intestinal motility following the arrival of nutrients, with additional effects including delaying gastric emptying and promoting satiety. 7,10 Motility brakes within the colon and rectum have also been described, though they remain less well established.Published examples include withholding de...

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Restoration of normal colonic motor patterns and meal responses after distal colorectal resection

Abstract: Motility patterns and meal responses are restored after distal colorectal resection in patients with normal bowel function. Coordinated propagation across healed anastomoses may indicate regeneration of underlying cellular networks.

Cited by 28 publications

References 40 publications

Bowel dysfunction after sigmoid resection for cancer and its impact on quality of life

Bowel dysfunction after sigmoid resection for cancer and its impact on quality of life

Hyperactive cyclic motor activity in the distal colon after colonic surgery as defined by high-resolution colonic manometry

The “rectosigmoid brake”: Review of an emerging neuromodulation target for colorectal functional disorders

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