High‐resolution colonic motility recordings <i>in vivo</i> compared with <i>ex vivo</i> recordings after colectomy, in patients with slow transit constipation

Dinning, Phil G.; Sia, Tiong Cheng; Kumar, Raghu; Rosli, Reizal Mohd; Kyloh, Melinda; Wattchow, David; Wiklendt, Lukasz; Brookes, Simon Jonathan; Costa, Marcello; Spencer, Nick J.

doi:10.1111/nmo.12884

Cited by 29 publications

(12 citation statements)

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“…Prospective studies are needed to identify the applications of HRCM and to provide criteria for its use in clinical practice. HRCM has a value in evaluating colonic motility in children with complex biopsychosocial disorders[52,53]. In most other colonic manometric studies, the presence or absence of HAPCs is used to distinguish between persons with colonic motility disorders and healthy people.…”

Section: New Colonic Manometry Techniquesmentioning

confidence: 99%

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

Fei

et al. 2019

WJCC

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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.

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Section: New Colonic Manometry Techniquesmentioning

confidence: 99%

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

Fei

et al. 2019

WJCC

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“…For instance, post-operative ileus, the temporary cessation of GIT motility following surgery, has a significant sympathetic component ( Behm and Stollman, 2003 ; Bauer and Boeckxstaens, 2004 ; Wattchow et al, 2020 ). Slow transit constipation is a debilitating disorder with a largely unknown aetiology, however, extrinsic sympathetic inputs running in the extrinsic nerves have been implicated ( Dinning et al, 2016 ). Gaining insight into the specific types of myenteric neurons targetted by varicose neurotransmitter released from sympathetic axons is therefore of clinical relevance.…”

Section: Introductionmentioning

confidence: 99%

Sympathetic Pathways Target Cholinergic Neurons in the Human Colonic Myenteric Plexus

et al. 2022

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BackgroundThe sympathetic nervous system inhibits human colonic motility largely by effects on enteric neurons. Noradrenergic axons, which branch extensively in the myenteric plexus, are integral to this modulatory role, but whether they contact specific types of enteric neurons is unknown. The purpose of this study was to determine the association of noradrenergic varicosities with types of enteric neurons.MethodsHuman colonic tissue from seven patients was fixed and dissected prior to multi-layer immunohistochemistry for human RNA binding proteins C and D (HuC/D) (pan-neuronal cell body labelling), tyrosine hydroxylase (TH, catecholaminergic labelling), Enkephalin (ENK), choline acetyltransferase (ChAT, cholinergic labelling) and/or nitric oxide synthase (NOS, nitrergic labelling) and imaged using confocal microscopy. TH-immunoreactive varicose nerve endings and myenteric cell bodies were reconstructed as three dimensional digital images. Data was exported to a purpose-built software package which quantified the density of varicosities close to the surface of each myenteric cell body.ResultsTH-immunoreactive varicosities had a greater mean density within 1 μm of the surface of ChAT +/NOS− nerve cell bodies compared with ChAT−/NOS + cell bodies. Similarly, ENK-immunoreactive varicosities also had a greater mean density close to ChAT +/NOS− cell bodies compared with ChAT−/NOS + cells.ConclusionA method for quantifying close associations between varicosities and nerve cell bodies was developed. Sympathetic axons in the myenteric plexus preferentially target cholinergic excitatory cells compared to nitrergic neurons (which are largely inhibitory). This connectivity is likely to be involved in inhibitory modulation of human colonic motility by the sympathetic nervous system.

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“…Resection of the parasympathetic pelvic splanchnic nerves causes loss of the defecation reflex ( Devroede and Lamarche, 1974 ). HAPWs are not observed in ex vivo preparations of the human colon ( Dinning et al, 2016 ). In the cat, HAPWs and HAPW-SPWs were identified in vivo and shown to be associated with firing of parasympathetic efferents ( De Groat and Krier, 1978 ).…”

Section: Introductionmentioning

confidence: 99%

Optimizing Autonomic Function Analysis via Heart Rate Variability Associated With Motor Activity of the Human Colon

et al. 2021

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The parameters of heart rate variability (HRV) can non-invasively assess some autonomic activities, and HRV is influenced by many bodily actions. Although parasympathetic activity is the primary driver of colonic propulsive activity, and sympathetic activity a major inhibitor of colonic motility, they are rarely measured and almost play no role in diagnosis of colon motor dysfunction or in standard treatments. Here we set out to optimize HRV analysis of autonomic nervous system changes related to human colon motility. The electrocardiogram and impedance were recorded in synchrony with colonic motor patterns by high-resolution manometry. Respiratory sinus arrhythmia (RSA), root mean square of successive differences of beat-to-beat intervals (RMSSD), the Baevsky Index or Sympathetic Index (SI), and the ratios of SI/RSA and SI/RMSSD were shown to indicate a marked increase in parasympathetic and withdrawal of sympathetic activity during the high-amplitude propagating pressure waves (HAPWs). Strong associations were seen with HAPWs evoked by a meal and rectal bisacodyl indicating a marked increase in parasympathetic and withdrawal of sympathetic activity during the gastrocolic reflex and the defecation reflex. When HAPWs occurred in quick succession, parasympathetic activation (RSA and RMSSD) occurred in a rhythmic fashion. Hence, during propulsive motor patterns, an overall shift in autonomic activity toward increased parasympathetic control was shown to be reflected in HRV. HRV assessment may therefore be valuable in the assessment of autonomic dysfunction related to colonic dysmotility.

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High‐resolution colonic motility recordings in vivo compared with ex vivo recordings after colectomy, in patients with slow transit constipation

Cited by 29 publications

References 50 publications

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

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

Sympathetic Pathways Target Cholinergic Neurons in the Human Colonic Myenteric Plexus

Optimizing Autonomic Function Analysis via Heart Rate Variability Associated With Motor Activity of the Human Colon

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