Twenty-four hour recordings of colonic motility in patients with diverticular disease

Bassotti, Gabrio; Battaglia, Edda; Spinozzi, Fabrizio; Pelli, Maria Antonietta; Tonini, Marcello

doi:10.1007/bf02234460

Cited by 114 publications

(92 citation statements)

References 28 publications

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“…Paradoxically, inflating a balloon in the colon of individuals with DD induces the musculature of the colonic wall to yield to the increasing luminal pressure more quickly than in controls [38,39] . In addition, these and later studies indicate increased colonic motility (as assessed by number and amplitude of bowel wall contractions) in the sigmoid colon of individuals with left-sided DD [40,41] , and also in the ascending colon of patients with right-sided diverticulosis [42] . These classical studies were generally performed with low numbers and failed to account for age, gender, physical activity or body fat percentage; the physiological observations were made under artificial conditions, i.e.…”

Section: Intra-luminal Pressure and Colonic Motilitymentioning

confidence: 79%

“…Furthermore, they were performed over one or two hours, with the subject at rest, whilst in reality one would expect variation in bowel pressures throughout the day. More recently however, Bassotti et al [41] made recordings over a 24 h period, and observed higher colonic motility in DD cases throughout the recording period than in a younger control group (cases 42-65 mmHg, controls 37-55 mmHg). It is unclear whether or not failing to control for age confounds these studies; Firth and Prather [43] suggest that colonic motility is not altered in the normal ageing colon, but this warrants further investigation, ideally utilizing pressure-sensitive transducers which can be swallowed and allowed to pass through the GI tract to provide more representative measures of colonic physiology [44] .…”

Section: Intra-luminal Pressure and Colonic Motilitymentioning

confidence: 97%

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Diet, ageing and genetic factors in the pathogenesis of diverticular disease

Commane¹,

Arasaradnam²,

Mills³

et al. 2009

WJG

116

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Diverticular disease (DD) is an age-related disorder of the large bowel which may affect half of the population over the age of 65 in the UK. This high prevalence ranks it as one of the most common bowel disorders in western nations. The majority of patients remain asymptomatic but there are associated life-threatening co-morbidities, which, given the large numbers of people with DD, translates into a considerable number of deaths per annum. Despite this public health burden, relatively little seems to be known about either the mechanisms of development or causality. In the 1970s, a model of DD formulated the concept that diverticula occur as a consequence of pressureinduced damage to the colon wall amongst those with a low intake of dietary fiber. In this review, we have examined the evidence regarding the influence of ageing, diet, inflammation and genetics on DD development. We argue that the evidence supporting the barotrauma hypothesis is largely anecdotal. We have also identified several gaps in the knowledge base which need to be filled before we can complete a model for the etiology of diverticular disease.

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Section: Intra-luminal Pressure and Colonic Motilitymentioning

confidence: 79%

Section: Intra-luminal Pressure and Colonic Motilitymentioning

confidence: 97%

Diet, ageing and genetic factors in the pathogenesis of diverticular disease

Commane¹,

Arasaradnam²,

Mills³

et al. 2009

WJG

116

View full text Add to dashboard Cite

show abstract

“…Twenty-four-hour colonic motor activity in both patients and controls was studied by a previously described manometric technique [23, 24, 25, 26]. After an overnight fast, an eight-lumen manometric probe with side holes spaced 12 cm apart (Arndorfer Medical Specialties, Greendale, Wisc., USA; outer diameter 4.5 mm, inner diameter for each lumen 0.8 mm) was introduced within the colon by the aid of a colonoscope.…”

Section: Patientsmentioning

confidence: 99%

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

Bassotti

Chistolini²,

Marinozzi³

et al. 2003

Digestion

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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.

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“…More recently, we investigated colonic motility in patients with symptomatic uncomplicated diverticular disease, by means of a 24-hour manometric technique that allows studying most of the viscus, its daily fluctuations [57] , and detection of the motor equivalents of mass movements, the so-called high-amplitude propagated contractions (HAPC) [58] . With respect to controls, patients with diverticulosis displayed a significantly overall increase of daily motor activity, except in the transverse colon (the segment not involved by diverticula), and of propulsive activity [59] . Interestingly, patients had several retropropagated HAPC (never observed in controls), and the motor activity of the affected segments, especially the sigmoid, was significantly higher than that of the unaffected ones (the transverse).…”

Section: Colonic Motilitymentioning

confidence: 86%

Pathophysiological aspects of diverticular disease of colon and role of large bowel motility

Bassotti

Chistolini²,

Morelli³

2003

WJG

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Colonic diverticular disease (diverticulosis) is one of the most common gastrointestinal disorders in Western countries. This disorder is strictly related to aging and fibre intake, and still bears a discrete amount of morbidity. Numerous etiological co-factors have to date been implicated in the pathogenesis of the disease, yet the supporting evidence is still far from absolute. The present review considers the pathophysiology of colonic diverticular disease, with a special emphasis on factors related to abnormal colonic motility.Bassotti G, Chistolini F, Morelli A. Pathophysiological aspects of diverticular disease of colon and role of large bowel motility.

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Twenty-four hour recordings of colonic motility in patients with diverticular disease

Abstract: We concluded that patients with diverticular disease of the colon have abnormal motor and propulsive activities of the large bowel, which are confined to the affected segments.

Cited by 114 publications

References 28 publications

Diet, ageing and genetic factors in the pathogenesis of diverticular disease

Diet, ageing and genetic factors in the pathogenesis of diverticular disease

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

Pathophysiological aspects of diverticular disease of colon and role of large bowel motility

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