Manometric investigation of the entire esophagus in healthy subjects and patients with high-amplitude peristaltic contractions

Dysphagia ◽  
1988 ◽  
Vol 3 (2) ◽  
pp. 93-96 ◽  
Author(s):  
Gabrio Bassotti ◽  
Giuseppe Bacci ◽  
Dino Biagini ◽  
Piero David ◽  
Gianfranco Alunni ◽  
...  
Keyword(s):  
Healthy Subjects ◽  
High Amplitude ◽  
Peristaltic Contractions

scholarly journals On the nature of high-amplitude propagating pressure waves in the human colon

2020 ◽  
Vol 318 (4) ◽  
pp. G646-G660 ◽  
Author(s):  
Natalija Milkova ◽  
Sean P. Parsons ◽  
Elyanne Ratcliffe ◽  
Jan D. Huizinga ◽  
Ji-Hong Chen
Keyword(s):  
Healthy Subjects ◽  
Motor Pattern ◽  
High Amplitude ◽  
Proximal Colon ◽  
Pressure Waves ◽  
Sphincter Pressure ◽  
Average Amplitude ◽  
Colonic Motor ◽  
Balloon Distention ◽  
Descending Colon

Characterization of high-amplitude propagating pressure waves (HAPWs or HAPCs) plays a key role in diagnosis of colon dysmotility using any type of colonic manometry. With the introduction of high-resolution manometry, more insight is gained into this most prominent propulsive motor pattern. Here, we use a water-perfused catheter with 84 sensors with intervals between measuring points of 1 cm throughout the colon, for 6–8 h, in 19 healthy subjects. The catheter contained a balloon to evoke distention. We explored as stimuli a meal, balloon distention, oral prucalopride, and bisacodyl injection, with a goal to optimally evoke HAPWs. We developed a quantitative measure of HAPW activity, the “HAPW Index.” Our protocol elicited 290 HAPWs. 21% of HAPWs were confined to the proximal colon with an average amplitude of 75.3 ± 3.3 mmHg and an average HAPW Index of 440 ± 58 mmHg·m·s. 29% of HAPWs started in the proximal colon and ended in the transverse or descending colon, with an average amplitude of 87.9 ± 3.1 mmHg and an average HAPW Index of 3,344 ± 356 mmHg·m·s. Forty-nine percent of HAPWs started and ended in the transverse or descending colon with an average amplitude of 109.3 ± 3.3 mmHg and an average HAPW Index of 2,071 ± 195 mmHg·m·s. HAPWs with and without simultaneous pressure waves (SPWs) initiated the colo-anal reflex, often abolishing 100% of anal sphincter pressure. Rectal bisacodyl and proximal balloon distention were the most optimal stimuli to evoke HAPWs. These measures now allow for a confident diagnosis of abnormal motility in patients with colonic motor dysfunction. NEW & NOTEWORTHY High-amplitude propagating pressure waves (HAPWs) were characterized using 84 sensors throughout the entire colon in healthy subjects, taking note of site of origin, site of termination, amplitude, and velocity, and to identify optimal stimuli to evoke HAPWs. Three categories of HAPWs were identified, including the associated colo-anal reflex. Proximal balloon distention and rectal bisacodyl were recognized as reliable stimuli for evoking HAPWs, and a HAPW Index was devised to quantify this essential colonic motor pattern.

Bradygastrias and Mixed Dysrhythmias

2003 ◽  
Keyword(s):  
Contractile Activity ◽  
Low Frequency ◽  
High Amplitude ◽  
Intraluminal Pressure ◽  
Pressure Sensing ◽  
Recording Channel ◽  
Low Amplitude ◽  
Peristaltic Contractions ◽  
The Relationship ◽  
Exact Origin

Bradygastrias are low-frequency electrogastrogram (EGG) waves that range from approximately 1.0 to 2.5 cycles per minute (cpm) . Some bradygastria waves are high amplitude and occupy the full scale of the EGG recording channel; others are very low amplitude and appear to be almost flatline. Bradygastrias have been recorded in patients with functional dyspepsia, diabetic and idiopathic gastropathy, and nausea of pregnancy. These patients have symptoms of abdominal discomfort, fullness, nausea, and vomiting. In this chapter, the causes of bradygastria patterns are reviewed and examples of bradygastrias are shown. EGGs also may have increased bradygastria and tachygastria waves, a pattern termed a mixed dysrhythmia. The exact origin of bradygastrias has been difficult to determine. In certain circumstances, the antrum contracts at 1.5 to 1.8 contractions per minute rather than the more recognized 3-per-minute contractions. Figure 8.1 indicates the relationship between EGG waves and low-frequency antral peristaltic contractions recorded from an intraluminal pressure sensing device during fasting and after infusion of erythromycin in healthy individuals. The antral contractions were recorded 3 and 1.5 cm from the pylorus. During fasting, 2-cpm EGG waves were present and correlated with 2-per-minute antral contractions. Each of these low-frequency contractions was associated with a low-frequency EGG wave (a negative deflection followed by a positive deflection). Irregular antral attractions also occur during fasting and may be reflected in the EGG as 1- to 2-cpm EGG waves. After erythromycin infusion, the EGG waves occurred at 1.0 to 1.5cpm and correlated with stronger antral contractions that occurred at the same frequency: 1.0 to 1.5 per minute. Thus, the bradygastria EGG frequencies correlated with the low-frequency antral contractions during fasting and after infusion of erythromycin. These studies indicate that, under certain conditions, bradygastria waves reflect low-frequency antral contractions. The fundus of the stomach normally contracts slowly at a rate from 0.5 to 1 contraction per minute.15 Thus, the low-frequency contractile activity of the fundus may also be reflected in the low frequency EGG signals in certain situations.

The effect of alosetron on High-Amplitude Peristaltic Contractions in non-constipated IBS patients and healthy volunteers

2000 ◽  
Vol 118 (4) ◽  
pp. A1165
Author(s):  
Cees H. Clemens ◽  
Melvin Samsom ◽  
Gerard P. van Berge Henegouwen ◽  
Kathryn E. Kersey ◽  
Martha Fabri ◽  
...  
Keyword(s):  
Healthy Volunteers ◽  
High Amplitude ◽  
Peristaltic Contractions

Reflex Responses in Upper Limb Muscles to Cutaneous Stimuli

1993 ◽  
Vol 20 (04) ◽  
pp. 271-278 ◽  
Author(s):  
R. Chen
Keyword(s):  
Stimulus Intensity ◽  
Upper Limb ◽  
Healthy Subjects ◽  
Voluntary Contraction ◽  
Cutaneous Reflexes ◽  
Focal Lesions ◽  
Normal Ranges ◽  
Conduction Velocities ◽  
Limb Muscles ◽  
Biphasic Responses

ABSTRACT:Cutaneous reflexes in the upper limb were elicited by stimulating digital nerves and recorded by averaging rectified EMG from proximal and distal upper limb muscles during voluntary contraction. Distal muscles often showed a triphasic response: an inhibition with onset about 50 ms (Il) followed by a facilitation with onset about 60 ms (E2) followed by another inhibition with onset about 80 ms (12). Proximal muscles generally showed biphasic responses beginning with facilitation or inhibition with onset at about 40 ms. Normal ranges for the amplitude of these components were established from recordings on 22 arms of 11 healthy subjects. An attempt was made to determine the alterent fibers responsible for the various components by varying the stimulus intensity, by causing ischemic block of larger fibers and by estimating the afferent conduction velocities. The central pathways mediating these reflexes were examined by estimating central delays and by studying patients with focal lesions

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