Unprepared human colon does not discriminate between solids and liquids

Proano, Maritza; Camilleri, M.; Phillips, Sidney F.; Thomforde, George M.; Brown, Manuel L.; Tucker, Russell L.

doi:10.1152/ajpgi.1991.260.1.g13

Cited by 11 publications

(8 citation statements)

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“…Colonic transit time (CTT) measurement with the use of radio‐opaque markers is a method for investigating the passage of colonic intraluminal contents throughout the colon. CTT correlates with the pattern of defecation 1 –3 and is comparable to the transit time measured with scintigraphic studies 1 , 4 . Overall colonic transit time can be measured by counting the radio‐opaque markers on the plain abdominal radiograph.…”

Section: Introductionmentioning

confidence: 63%

Effect of bowel cleansing on colonic transit in constipation due to slow transit or evacuation disorder

Sloots

Felt‐Bersma

2002

Neurogastroenterology Motil

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Colon transit time measurement with radio-opaque markers is a method of studying the passage of luminal contents throughout the colon. Overall colonic transit time (CTT), as well as segmental transit times [right (RTT), left (LTT) and rectosigmoid (RSTT)], can be calculated. We hypothesize that CTT is influenced by faecal impaction when the rectum is emptied infrequently. The aim of this study is to investigate the effect of bowel cleansing on colonic transit time in patients with chronic constipation. In 25 women (age 41 years; range 20-65 years) with constipation according to Thompson criteria, CTT measurement was performed in an unprepared situation and repeated after cleansing with 4 L of Klean-Prepreg. Ten healthy female volunteers (age 41 years; range 27-57 years) were used as controls. In constipated patients, CTT decreased from a median 70 h (range 10-130 h) to 48 h (5-94 h) in the cleansed state (P < 0.001). A shortening of transit time was found in all three segments. In 10 patients with slow transit (ST) (CTT > 86 h), CTT decreased from 110 h (range 94-130) to 86 (38-94) (P < 0.001). Five of the 10 patients with ST before bowel cleansing had a CTT below 86 h after cleansing. In female controls, uncleansed CTT and RSTT shortened from 39 h (23 to 62) and 17 h (8-29) to 29 h (17-48) and 10 h (0-20) after bowel cleansing (P=0.058 and P=0.046). Colonic intraluminal contents have a substantial effect on colonic transit. In female controls, bowel cleansing shortened rectosigmoid transit. Women with constipation had faster transit in the cleansed state, however, the distribution of markers was not altered. Despite the effect of bowel cleansing on CTT, it seems unnecessary to prepare the bowel in clinical practice because the differentiation of patients between slow transit constipation and outlet obstruction is not changed. However, because in an infrequent defecation pattern, the influence of faecal impaction is considerable, CTT should be applied with care for critical clinical decisions in the treatment of constipation.

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Section: Introductionmentioning

confidence: 63%

Effect of bowel cleansing on colonic transit in constipation due to slow transit or evacuation disorder

Sloots

Felt‐Bersma

2002

Neurogastroenterology Motil

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“…33,34 Within the physiological range of rates of delivery of liquid to the ascending colon,¯uids and solids have comparable transit. 27,35 Recent studies in humans have examined the physical properties of the wall (e.g. compliance and colonic tone) and sensory function of different regions of the colon.…”

Section: Assessment Of Colonic Motor Functionmentioning

confidence: 99%

“…34 Within the physiological range of rates of delivery of liquid to the ascending colon, fluids and solids have comparable transit 27 , . 35 …”

Section: Introductionmentioning

confidence: 99%

Review article: colonic sensorimotor physiology in health, and its alteration in constipation and diarrhoeal disorders

Camilleri

Ford

1998

Aliment Pharmacol Ther

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Aim: To review the physiology of colonic motility and sensation in healthy humans and the pathophysiological changes associated with constipation and diarrhoea. Source: Medline Search from 1965 using the index terms: human, colonic motility, sensation, pharmacology, neurohormonal control, gastrointestinal transit, constipation, diarrhoea and combinations of these. Results: In health, the ascending and transverse regions of colon function as reservoirs to accommodate ileal chyme and the descending colon acts as a conduit; the neuromuscular functions and transmitters control colonic motility and sensation and play pivotal roles in disorders associated with constipation and/or diarrhoea. Disorders of proximal colonic transit contribute to symptoms in idiopathic constipation, diarrhoea‐predominant irritable bowel syndrome and carcinoid diarrhoea. Colonic function in patients presenting with constipation is best assessed clinically by colonic transit time using radiopaque markers ingested orally. Measurements of colonic contractility are less useful clinically but they can help identify motor abnormalities including colonic inertia; in some patients with irritable bowel syndrome, abdominal pain, urgency and diarrhoea are temporally associated with high amplitude contractions, which originate in the proximal colon and traverse the distal conduit at very high propagation velocities. Visceral hypersensitivity contributes to the urgency and tenesmus in irritable bowel syndrome and inflammatory bowel disease. Colonic motility and sensation can be reduced by anticholinergic agents, somatostatin analogues and 5HT3 antagonists. Conclusion: Physiological and pharmacological studies of the human colon have provided new insights into the pathophysiology of colonic disorders, and offer possibilities of novel therapeutic approaches for constipation or diarrhoea associated with colonic motor or sensory dysfunction.

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“…Scintigraphy is an adequate method to measure GI motility in the upper and lower GI tract as we and others already published 17–23 …”

Section: Methodsmentioning

confidence: 99%

The effect of naloxone‐3‐glucuronide on colonic transit time in healthy men after acute morphine administration: a placebo‐controlled double‐blinded crossover preclinical volunteer study

Netzer

Sendensky

Wissmeyer

et al. 2008

Aliment Pharmacol Ther

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Unprepared human colon does not discriminate between solids and liquids

Cited by 11 publications

References 0 publications

Effect of bowel cleansing on colonic transit in constipation due to slow transit or evacuation disorder

Effect of bowel cleansing on colonic transit in constipation due to slow transit or evacuation disorder

Review article: colonic sensorimotor physiology in health, and its alteration in constipation and diarrhoeal disorders

The effect of naloxone‐3‐glucuronide on colonic transit time in healthy men after acute morphine administration: a placebo‐controlled double‐blinded crossover preclinical volunteer study

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