Document Detail


Heightened colon motor activity measured by a wireless capsule in patients with constipation: relation to colon transit and IBS.
MedLine Citation:
PMID:  19808653     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Relationships of regional colonic motility to transit in health, constipation, and constipation-predominant irritable bowel syndrome (C-IBS) are poorly characterized. This study aimed to 1) characterize regional differences in colon pressure, 2) relate motor differences in constipation to colon transit, and 3) quantify the role of IBS in altered contractility with constipation. Colon pH and pressure were measured by wireless capsules in 53 healthy and 36 constipated subjects. Numbers of contractions >25 mmHg and areas under curves (AUC) were calculated for colon transit quartiles by time. Constipation was classified as normal transit (<59 h), moderate slow transit (STC) (59-100 h), and severe STC (>100 h). Twelve out of 36 constipated subjects had C-IBS; 24 had functional constipation. Numbers of contractions and AUCs increased from the first to the fourth quartile in health (P < 0.0001). Mean numbers of contractions in constipated subjects were similar to controls. Mean AUCs with normal transit (P = 0.01) and moderate STC (P = 0.004) but not severe STC (P = NS) were higher than healthy subjects. IBS was associated with greater mean numbers of contractions (P = 0.05) and AUCs (P = 0.0006) vs. controls independent of transit. Numbers of contractions increased from the first to fourth quartiles in moderate STC, C-IBS, and functional constipation; AUCs increased from the first to fourth quartiles in all groups (all P < 0.05). In conclusion, colon pressure activity is greater distally than proximally in health. Constipated patients with normal or moderately delayed transit show increased motor activity that is partly explained by IBS. These findings emphasize differential effects on transit and motility in different constipation subtypes.
Authors:
William L Hasler; Richard J Saad; Satish S Rao; Gregory E Wilding; Henry P Parkman; Kenneth L Koch; Richard W McCallum; Braden Kuo; Irene Sarosiek; Michael D Sitrin; John R Semler; William D Chey
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-10-01
Journal Detail:
Title:  American journal of physiology. Gastrointestinal and liver physiology     Volume:  297     ISSN:  1522-1547     ISO Abbreviation:  Am. J. Physiol. Gastrointest. Liver Physiol.     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-12-01     Completed Date:  2009-12-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100901227     Medline TA:  Am J Physiol Gastrointest Liver Physiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  G1107-14     Citation Subset:  IM    
Affiliation:
University of Michigan Health System, Ann Arbor, Michigan, USA. whasler@umich.edu
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MeSH Terms
Descriptor/Qualifier:
Area Under Curve
Capsule Endoscopy*
Case-Control Studies
Colon / physiopathology*
Colonoscopy*
Constipation / diagnosis,  etiology,  physiopathology*
Female
Gastrointestinal Transit*
Humans
Hydrogen-Ion Concentration
Irritable Bowel Syndrome / complications,  diagnosis,  physiopathology*
Linear Models
Male
Middle Aged
Muscle Contraction
Muscle, Smooth / physiopathology*
Pressure
Questionnaires
Severity of Illness Index

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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