Relationship between terminal ileal pressure waves and propagating proximal colonic pressure waves

The relationship between propagating distal ileal and proximal colonic moto r patterns has not been systematically examined in humans. Our aim was to d efine the relationships, if any, between prolonged propagating contractions or discrete clustered contractions and cecal propagating sequences using m ultiple manometric recording sites spanning the distal ileum and unprepared colon. In 14 healthy volunteers, a 17-lumen-perfused silicon catheter was positioned pernasally such that at least three recording sites lay in the i leum and the remainder in the colon. Intersidehole distance was 7.5 cm. In 271 h of recording, 30% of the terminal ileal propagating events was tempor ally associated with cecal propagating sequences. Significantly more prolon ged propagating contractions (11 of 24, 46%; P = 0.02) were associated with cecal propagating sequences than were associated with ileal discrete clust ered contractions (4 of 26, 15%). This trend was more pronounced at night. Of 159 cecal propagating sequences, 15 (9%) were preceded by an ileal propa gating event. The remaining 91% was preceded by increased non-propagating a ctivity commencing 2 min before the cecal propagating sequence (P = 0.0002) . We conclude that distal ileal propagating motor patterns are one stimulus for cecal propagating sequences, with the association being stronger for p rolonged propagating contractions than for discrete clustered contractions.