Effect of colonic distension on small bowel motility measured by jejunal high‐resolution manometry

Abstract

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Clinical significance of small bowel manometry patterns suggestive of intestinal obstruction

“…Vis-a-vis this information, we recently performed an experimental study in healthy subjects, to determine the effect of colonic filling on small bowel motility. 28 The study showed that mild colonic filling with gas triggered a long-distance retrograde reflex: high-resolution jejunal manometry detected repeat fronts of propagated contractions, with inhibition of background of segmental contractions, a motor pattern reminiscent of the minute rhythm pattern described in this study. Conceivably, advances in the recording techniques will help to understand the significance of reactive small bowel propagated activity.…”

“…We acknowledge that the value of these non‐systematic and retrospective observations is orientative at most, but it may indicate that the minute rhythm pattern may be related to a reaction to downstream pooling of contents and dumped flow; hence, it could be speculated that under these circumstances, the manometric pattern reflects a reactive pattern triggered by fecal retention. Vis‐a‐vis this information, we recently performed an experimental study in healthy subjects, to determine the effect of colonic filling on small bowel motility 28 . The study showed that mild colonic filling with gas triggered a long‐distance retrograde reflex: high‐resolution jejunal manometry detected repeat fronts of propagated contractions, with inhibition of background of segmental contractions, a motor pattern reminiscent of the minute rhythm pattern described in this study.…”

“…Passage of chyme into the small bowel during the postprandial period may activate small bowel motility in case of downstream resistance to flow; indeed, in the experimental study in healthy subjects, colonic gas filling during fasting conditions did not modify small bowel activity, and the reactive pattern was only triggered with concomitant infusion of nutrients in the small bowel. 28 We also acknowledge that in this retrospective study the adscription of individual patients to each category may be questionable, but this does not invalidate the broad observations on the etiology of MRP and PSC, particularly of luminal obstruction and intestinal neuropathy, and the potential role of colonic fecal retention in case of undetermined origin. As a practical implication, colonic preparation may be recommended prior to intestinal manometry.…”

“…Passage of chyme into the small bowel during the postprandial period may activate small bowel motility in case of downstream resistance to flow; indeed, in the experimental study in healthy subjects, colonic gas filling during fasting conditions did not modify small bowel activity, and the reactive pattern was only triggered with concomitant infusion of nutrients in the small bowel. 28 …”

Distinctive gastrointestinal motor dysfunction in patients with MNGIE

“…Small bowel motility was evaluated by a high‐resolution intestinal manometry system, as previously described 8,9 . Briefly, after an overnight fast, a customized 35‐channel water‐perfused manometry catheter designed to measure jejunal motility (Mui Scientific) was orally introduced into the jejunum under fluoroscopic guidance.…”