Colonic Intraluminal Pressure in Functional Bowel Disorders

Abstract

For the simultaneous recording of the intraluminal pressure in proximal and sigmoid colon, we designed a new method named endoscopic retrograde bowel insertion method (ERBI method). Thirty subjects studied were consisted of 7 normal controls, 9 patients with diarrhea and 14 patients with constipation, The basal pressure was recorded for 15 minutes and then O. 5 mg of prostigmin was given i. m. and the pressure was measured for the periods of 60 minutes. The true effect of prostigmin appeared to begin about 15 minutes after the injection and end about 40 minutes after the injection. For qualitative analysis, colonic motility index (CMI) was calculated from basal 15 minutes recordings and 30 minutes after an interval of 15 minutes from the injection of prostigmin. Constipation was classified into two groups according to the patient's reaction to prostigmin in sigmoid colon : one was the hyperactive group which showed CMI over 200,another was the hypoactive group which showed CMI under 200. The former corresponded to spastic constipation in irritable bowel syndrome and the latter corresponded to simple constipation. In the normal control, and in diarrhea and simple constipation, proximal colon was more active than sigmoid colon, whereas in spastic constipation, sigmoid colon was significantly much more active than proximal colon in basal and after prostigmin. In diarrhea the pressure was diminished in the proximal and sigmoid colon. Furthermore, there was a statistically significant correlation between the basal sigmoid pressure and aging.