Propagation Characteristics of Fasting Duodeno-Jejunal Contractions in Healthy Controls Measured by Clustered Closely-spaced Manometric Sensors

Abstract

Background/AimsHigh-resolution methods have advanced esophageal and anorectal manometry interpretation but are incompletely established for intestinal manometry. We characterized normal fasting duodeno-jejunal manometry parameters not measurable by standard techniques using clustered closely-spaced recordings.MethodsTen fasting recordings were performed in 8 healthy controls using catheters with 3–4 gastrointestinal manometry clusters with 1–2 cm channel spacing. Migrating motor complex phase III characteristics were quantified. Spatial-temporal contour plots measured propagation direction and velocity of individual contractions. Coupling was defined by pressure peak continuity within clusters.ResultsTwenty-three phase III complexes (11 antral, 12 intestinal origin) with 157 (95% CI, 104–211) minute periodicities, 6.99 (6.25–7.74) minute durations, 10.92 (10.68–11.16) cycle/minute frequencies, 73.6 (67.7–79.5) mmHg maximal amplitudes, and 4.20 (3.18–5.22) cm/minute propagation velocities were recorded. Coupling of individual contractions was 39.1% (32.1–46.1); 63.0% (54.4–71.6) of contractions were antegrade and 32.8% (24.1–41.5) were retrograde. Individual phase III contractions propagated > 35 fold faster (2.48 cm/sec; 95% CI, 2.25–2.71) than complexes themselves. Phase III complexes beyond the proximal jejunum were longer in duration (P = 0.025) and had poorer contractile coupling (P = 0.025) than proximal complexes. Coupling was greater with 1 cm channel spacing vs 2 cm (P < 0.001).ConclusionsIntestinal manometry using clustered closely-spaced pressure ports characterizes novel antegrade and retrograde propagation and coupling properties which degrade in more distal jejunal segments. Coupling is greater with more closely-spaced recordings. Applying similar methods to dysmotility syndromes will define the relevance of these methods.

Enhancing the utility of antroduodenal manometry in pediatric intestinal pseudo‐obstruction

“…8,11,40 Although several studies demonstrated a retrograde component could present within the sequences of phase III (varying from 30%-70%), [41][42][43][44][45] phase III complexes often show net antegrade propagation. 41,46 Thus, we gave a score of zero for a phase III complex with fully anterograde propagation, and a higher score which indicated a less percentage of anterograde direction.…”

Intestinal Permeability and Drug Absorption: Predictive Experimental, Computational and In Vivo Approaches

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Propagation patterns of jejunal motor activity measured by high‐resolution water‐perfused manometry

“…The superiority of multiple, closely spaced sensors in the evaluation of propagated activity has been previously described both in the small bowel and colonic studies. [18][19][20] The catheter designed was custom-made, but the rest of the perfusion manometry equipment is standard. Intubation was uneventful in all participants and the test was well tolerated.…”