High-resolution colonic manometry and its clinical application in patients with colonic dysmotility: A review

Abstract

The detailed process and mechanism of colonic motility are still unclear, and colonic motility disorders are associated with numerous clinical diseases. Colonic manometry is considered to the most direct means of evaluating colonic peristalsis. Colonic manometry has been studied for more than 30 years; however, the long duration of the examination, high risk of catheterization, huge amount of real-time data, strict catheter sterilization, and high cost of disposable equipment restrict its wide application in clinical practice. Recently, high-resolution colonic manometry (HRCM) has rapidly developed into a major technique for obtaining more effective information involved in the physiology and/or pathophysiology of colonic contractile activity in colonic dysmotility patients. This review focuses on colonic motility, manometry, operation, and motor patterns, and the clinical application of HRCM. Furthermore, the limitations, future directions, and potential usefulness of HRCM in the evaluation of clinical treatment effects are also discussed.

Contractility patterns and gastrointestinal movements monitored by a combined magnetic tracking and motility testing unit

“…traverses from the ileum to ascending colon. During the ICJ transit of the combi-unit, we found:(1) the specific site of the ICJ happened 126 s before the pH drop, which confirmed previous observations TA B L E 3 Movements and motor patterns in combined ascending, transverse and descending colon at each continuous contraction series CCS: Continuous contraction series, which is a group of conjunct continuous contraction patterns. There were in total 9 CCS from the ascending to the descending colon with numbers from 1 to 9.Abbreviations: FA, Fast antegrade movement; FR, fast retrograde movement; SA, Slow antegrade movement; SR, Slow retrograde movement.with concurrent scintigraphic and WMC measurements 32 ; (2) Before the combi-unit emptied from the ileum, the pressure amplitude increased with significant antegrade and retrograde movement at the terminal ileum part (Figure4B); and (3) the contraction pattern continued after the ICJ passage of the combi-unit, and the transmitted ileal motor contraction propelled the combi-unit further along the ascending colon with a long-distance progressive movement (Figure5Aand D).…”

“…Gastrointestinal (GI) motility is usually described in terms of regional transit or changes of intraluminal pressure. Motility processes have been widely investigated with technologies including manometry, 1,2 radiopaque markers, 3 and ingestible wireless capsule devices 4–8 9–15 .…”

Evaluating Performance of Circular Staplers Using Comparative Test Methods for Evidence-Based Surgery

“…The failure point of each sample was recorded and all samples that leaked below 50 mmHg were considered to be representative of potential post-operative leaks based on published evidence, which suggests that low-amplitude propagated contractions (LAPC) in the colon generate pressures that typically range from 5-40 mmHg and do not exceed 50 mmHg. 21 Therefore, a sample that could withstand 50 mmHg could be reasonably expected to maintain its integrity and prevent leak in a post-operative environment. For these tests a total of 18 firings were completed, with n = 6 gastrojejunostomy and n = 3 colonic firings per stapler.…”

“…Leaks at the staple line were evaluated based on published evidence, which suggests that post-operative low-amplitude propagated contractions (LAPC) in the colon generate pressures that typically range from 5-40 mmHg and do not exceed 50 mmHg. 21 For the purposes of assessing device performance, 50 mmHg was used as a pass/fail point because it represents the maximum expected postoperative LAPC. Therefore, any device that surpasses this leak pressure would be expected to withstand normal colonic function.…”

Luminal Fluid Motion Inside an In Vitro Dissolution Model of the Human Ascending Colon Assessed Using Magnetic Resonance Imaging

“…Manometry techniques are used to measure intraluminal pressure activity during contractions of the colonic wall, with significant advances being made using high resolution manometry in recent years [8][9][10][11]. However, little information is available pertaining to how the colonic contents move and particularly, changes in movement based on motility patterns associated with both normal and abnormal colon pathophysiology [12].…”