Manometric techniques for the evaluation of colonic motor activity: current status

Authors

  • S. M. Scott

    1. Academic Department of Surgery (GI Physiology Unit), Barts and the London, Queen Mary School of Medicine & Dentistry, The Royal London Hospital, Whitechapel, London, UK
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Dr Mark Scott, GI Physiology Unit, 3rd Floor, Alexandra Wing, The Royal London Hospital, London, E1 1BB, UK.
Tel.: 020 7377 7194; fax: 020 7377 7346;
e-mail: m.scott@qmul.ac.uk

Abstract

Colonic motility disorders are common conditions. However, our understanding of normal, and, consequently, pathological motor function of the colon remains limited, mainly due to the relative inaccessibility of this organ for study. Investigation of colonic motility may encompass one or more of the four separate components (myoelectric activity, phasic and tonic contractile activity and movement of intraluminal content) using electrophysiological, manometric or transit studies. Although transit studies provide the best ‘functional’ appreciation of colonic motor activity, and are the only techniques used in contemporary clinical practice, manometric methods are becoming increasingly popular, as they allow a direct study of colonic contractile activity over prolonged periods. To date, the majority of studies have been limited to the pelvic colon by a retrograde (per rectal) approach; however, recent technological advances have facilitated ‘pan-colonic’ investigation. This review concentrates on manometry of the human colon proximal to the sigmoid, and includes evaluation of both phasic and tonic motor activity, by utilization of perfused-tube and solid-state manometric catheters, and also the electronic barostat. Methodological techniques, experimental protocols and the analysis and interpretation of recorded data are critically explored, and a contemporary classification of colonic contractile activities is presented.

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