Characterization of a Hyperactive Segment at the Rectosigmoid Junction

Ah, Chowdhury; Dinoso, Vicente P.; Lorber, Stanley H.

doi:10.1016/s0016-5085(76)80546-x

Cited by 67 publications

(3 citation statements)

References 15 publications

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“…The median duration of symptoms was 6 years (range 1. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20], prior to the study. The median stool frequency was 3 month )1 (range 1-4).…”

Section: Resultsmentioning

confidence: 99%

“…either decreased motor activity, with a consequent lack of propulsion of intraluminal contents, 14,15,16 or increased motor activity which may act as a brake to the intraluminal flow of colonic contents. 17,18,19 To date, the techniques employed in the study of colonic motor activity in constipation, whether manometric or electrophysiological, have employed bowel preparation, and has made it mandatory for the subject to be non-ambulant in a laboratory environment. As both stress 20,21 and exercise 22 can perturb colonic motor activity, the published data may not be representative of the pathophysiology of chronic idiopathic constipation as the data was collected under nonphysiological conditions.…”

Section: Introductionmentioning

confidence: 99%

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Colonic motor activity in slow‐transit idiopathic constipation as identified by 24‐h pancolonic ambulatory manometry

Hagger¹,

Kumar²,

Benson

et al. 2003

Neurogastroenterology Motil

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Colorectal motor activity in slow-transit idiopathic constipation has not been fully evaluated under physiological conditions. The aim of this study was to evaluate colorectal motor activity in chronic idiopathic constipation using 24-h ambulant pancolonic manometry. Ten healthy volunteers (six females) 19-31 years of age, and eight females 25-46 years of age with slow-transit idiopathic constipation were studied. Motor activity was measured using two custom-made silicone-coated catheters, each with five solid-state pressure transducers. Bowel preparation or sedation was not used. Frequency of high-amplitude propagated contractions was reduced in chronic idiopathic constipation, median 1.9/24 h vs 6/24 h (P = 0.01). Contractile frequency of low-amplitude complexes was reduced throughout the colon in slow-transit idiopathic constipation (P < 0.0001). The interval between contractile complexes was reduced in the transverse colon and splenic flexure (P < 0.0001). This study demonstrates that colonic motor activity is abnormal in slow-transit idiopathic constipation; decreased motor activity leads to a reduction in propulsion of intraluminal contents.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Colonic motor activity in slow‐transit idiopathic constipation as identified by 24‐h pancolonic ambulatory manometry

Hagger¹,

Kumar²,

Benson

et al. 2003

Neurogastroenterology Motil

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“…These patients complained of abdominal pain more frequently. Some authors have already hypothesized that an abnormal increase in this rhythmic pattern, particularly common at the recto‐sigmoid junction, might be responsible for some cases of constipation, leading to functional obstruction 31,32 while radionuclide studies have demonstrated that the sigmoid area could be a possible brake for the propulsion of colonic content 33,34 . On the contrary, recent data obtained with ambulatory manometry suggest that both contractile frequency of rectal complex and the interval between complexes are increased leading to the conclusion that this localized increased motor activity is not responsible to flow obstruction 35 .…”

Section: Discussionmentioning

confidence: 99%

Results of 24‐h manometric recording of colonic motor activity with endoluminal instillation of bisacodyl in patients with severe chronic slow transit constipation

Hervé

Savoye

Behbahani

et al. 2004

Neurogastroenterology Motil

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The aims of this study were to assess the prevalence of manometric colonic abnormalities and to evaluate the motor effect of intraluminal bisacodyl in a cohort of refractory constipated patients. Twenty-four hour colonic motility recordings were performed in 40 patients referred for a severe intractable chronic constipation. At the end of each recording session the motor effects of the endoluminal instillation of 10 mg bisacodyl were assessed. These patients were compared with 20 healthy subjects. The number of high-amplitude propagating contractions (HAPC) was significantly decreased in patients with slow transit constipation (12 +/- 11.6 vs 1 +/- 8.6, P < 0.001). Based on manometric patterns four groups of patients were isolated. Ten patients had no spontaneous HAPC, no food-induced colonic motor response and significantly lower colonic activity in transverse colon (374 +/- 1220 vs 3249 +/- 3458, P < 0.05). Five patients had significantly increased sigmoid segmental motility (20298 +/- 6364 vs 88780 +/- 3643, P < 0.001) and eight patients had significantly lower number of HAPC without other manometric abnormalities while 17 patients had normal colonic motility recordings. Endoluminal bisacodyl was able to induce HAPCs in all groups of patients. Patients with severe slow transit refractory constipation represented a heterogeneous group and endoluminal bisacodyl was able to promote a propagated motor activity in a majority of patients even in those suspected of having an inert colon.

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Relationship between outlet obstruction constipation and obstructed urinary flow

Macdonald

Shearer

Paterson

et al. 1991

Journal of British Surgery

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Ten women with symptoms and radiological features of outlet obstruction constipation underwent urodynamic bladder studies. The results were compared with ten age- and sex-matched controls. The mean (s.e.m.) peak flow rate for patients was 19.4 (6.4) ml/s compared with 32.1 (7.2) ml/s for controls (P less than 0.05). The mean (s.e.m.) voiding time for patients was 62.9 (23.7) s against a corresponding value of 15.6 (6) for controls (P less than 0.05). The mean (s.e.m.) bladder volume in patients was 482 (80) ml compared with a control value of 254 (112) ml (P less than 0.03). The mean (s.e.m.) detrusor pressure during the voiding phase was 53.3 (12) cmH2O. These results demonstrate that patients with outlet obstruction constipation have a generalized pelvic floor disorder resulting in obstructed urinary flow.

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Characterization of a Hyperactive Segment at the Rectosigmoid Junction

Cited by 67 publications

References 15 publications

Colonic motor activity in slow‐transit idiopathic constipation as identified by 24‐h pancolonic ambulatory manometry

Colonic motor activity in slow‐transit idiopathic constipation as identified by 24‐h pancolonic ambulatory manometry

Results of 24‐h manometric recording of colonic motor activity with endoluminal instillation of bisacodyl in patients with severe chronic slow transit constipation

Relationship between outlet obstruction constipation and obstructed urinary flow

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