Prolonged multi-point recording of colonic manometry in the unprepared human colon: Providing insight into potentially relevant pressure wave parameters

OBJECTIVES: To determine the feasibility of and derive normative data for p rolonged, 24-h, multipoint, closely spaced, water perfused manometry of the unprepared human colon. METHODS: In 14 healthy volunteers, 24-h recordings were made using a water perfused, balloon-tipped, 17 lumen catheter which was passed pernasally and positioned so that 16 recording sites spanned the colon at 7.5 cm interval s from cecum to rectum. The area under the pressure curve and propagating p ressure wave parameters were quantified for the 16 regions. High amplitude propagating sequences were defined as were rectal motor complexes. RESULTS: Nasocolonic recording was well tolerated and achievable. Propagati on sequences, including high amplitude propagating sequences, originated in the cecum (0.32 +/- 0.05/h) more frequently than in other regions and the extent of propagation correlated significantly with proximity of the site o f sequence origin to the cecum (p < 0.001). Propagation velocity of propaga ting sequences was greater than high amplitude propagating sequences (p = 0 .0002) and region-dependent, unlike high amplitude propagating sequences (p < 0.01). The frequency of propagating sequences did not increase after the meal, but frequency of high amplitude propagating sequences was increased significantly by the meal (p < 0.01). Rectal motor complexes were seen thro ughout the colon with no apparent periodicity. CONCLUSIONS: Prolonged, multipoint, perfusion manometry of the unprepared c olon provides improved spatial resolution of colonic motor patterns and con firms the diurnal and regional variations in propagating pressure waves det ected in the prepared colon. The study demonstrates differences between hig h amplitude propagating sequences and propagating sequence parameters that may have functional significance; and also, that the rectal motor complex i s a ubiquitous pan colonic motor pattern. (C) 2001 by Am. Cell. of Gastroen terology.