Pancolonic spatiotemporal mapping reveals regional deficiencies in, and disorganization of colonic propagating pressure waves in severe constipation
Article first published online: 6 SEP 2010
© 2010 Blackwell Publishing Ltd
Neurogastroenterology & Motility
Volume 22, Issue 12, pages e340–e349, December 2010
How to Cite
Dinning, P. G., Zarate, N., Hunt, L. M., Fuentealba, S. E., Mohammed, S. D., Szczesniak, M. M., Lubowski, D. Z., Preston, S. L., Fairclough, P. D., Lunniss, P. J., Scott, S. M. and Cook, I. J. (2010), Pancolonic spatiotemporal mapping reveals regional deficiencies in, and disorganization of colonic propagating pressure waves in severe constipation. Neurogastroenterology & Motility, 22: e340–e349. doi: 10.1111/j.1365-2982.2010.01597.x
- Issue published online: 4 NOV 2010
- Article first published online: 6 SEP 2010
- Received: 6 July 2010 Accepted for publication: 9 August 2010
- propagating sequences
Background The morphology, motor responses and spatiotemporal organization among colonic propagating sequences (PS) have never been defined throughout the entire colon of patients with slow transit constipation (STC). Utilizing the technique of spatiotemporal mapping, we aimed to demonstrate ‘manometric signatures’ that may serve as biomarkers of the disorder.
Methods In 14 female patients with scintigraphically confirmed STC, and eight healthy female controls, a silicone catheter with 16 recording sites spanning the colon at 7.5 cm intervals was positioned colonoscopically with the tip clipped to the cecum. Intraluminal pressures were recorded for 24 h.
Key Results Pan-colonic, 24 h, spatiotemporal mapping identified for the first time in STC patients: a marked paucity of propagating pressure waves in the mid-colon (P = 0.01), as a consequence of a significant (P < 0.0001) decrease in extent of propagation of PS originating in the proximal colon; an increase in frequency of retrograde PS in the proximal colon; a significant reduction in the spatiotemporal organization among PS (P < 0.001); absence of the normal nocturnal suppression of PS.
Conclusions & Inferences Pan-colonic, 24 h, spatiotemporal pressure mapping readily identifies characteristic disorganization among consecutive PS, regions of diminished activity and absent or deficient fundamental motor patterns and responses to physiological stimuli. These features are all likely to be important in the pathophysiology of slow transit constipation.