Characterization of haustral activity in the human colon

The human colon consists of a string of haustral compartments; hence all colonic motility involves haustra, yet contraction patterns are rarely discussed from the perspective of haustra. Haustral activity was analyzed in 21 healthy subjects using an 84-sensor manometry catheter with 1 cm spacing; haustra were on average 4.6 cm long, hence their activity was monitored by 4-5 sensors. On average 47% of the haustra were intermittently active for ~ 30% of the time; 2402 periods of haustra activity were analyzed. Intrahaustral activity showed rhythmic pressure waves centred around a frequency of 2-6 cpm or 7-15 cpm, or a checkerboard segmentation pattern. Boundaries of the haustra showed rhythmic pressure activity at a dominant frequency pf 3 cpm with or without elevated baseline pressure. The haustral activity was a low-amplitude motor pattern, 5-30 mmHg above baseline pressure. The intrahaustral rhythmic pressure waves propagated in a mixed pattern: retrograde, antegrade and simultaneous, with the simultaneous appearance dominating. Active haustra often showed no boundary activity probably allowing transit to neighbouring haustra. Haustral boundaries are seen at the same sensor for the 6-8 hr study duration, indicating that they do not propagate. Based on previous studies we infer that the orchestration of haustral activity involves pacemaker activity from ICC-SMP. High amplitude propagating pressure waves (HAPWs), were often followed by a cyclic motor pattern at a frequency ~ 12 cpm dissolving into haustral activity at that frequency. The HAPW may be composed of neurally-induced summated pressure waves at ~ 12 cpm.

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

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.00386.2019 ◽

2020 ◽

Vol 318 (4) ◽

pp. G646-G660 ◽

Cited By ~ 8

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.

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A296 A RHYTHMIC MOTOR PATTERN ASSOCIATED WITH HIGH AMPLITUDE PRESSURE WAVES IN HUMAN HIGH-RESOLUTION COLONIC MANOMETRY

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwy009.296 ◽

2018 ◽

Vol 1 (suppl_2) ◽

pp. 425-426

Author(s):

J Chen ◽

M Pervez ◽

E Ratcliffe ◽

D Armstrong ◽

P Bercik ◽

...

Keyword(s):

High Resolution ◽

Motor Pattern ◽

High Amplitude ◽

Pressure Waves ◽

Rhythmic Motor ◽

Colonic Manometry ◽

Rhythmic Motor Pattern

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Fr431 ANALYSIS OF AUTONOMIC NERVOUS SYSTEM REACTIVITY ASSOCIATED WITH HIGH-AMPLITUDE PROPAGATING PRESSURE WAVES OF THE HUMAN COLON IN HEALTHY SUBJECTS

Gastroenterology ◽

10.1016/s0016-5085(21)01472-4 ◽

2021 ◽

Vol 160 (6) ◽

pp. S-315

Author(s):

M. Khawar Ali ◽

Lijun Liu ◽

Jihong Chen ◽

Jan D. Huizinga

Keyword(s):

Nervous System ◽

Autonomic Nervous System ◽

Healthy Subjects ◽

Human Colon ◽

High Amplitude ◽

Pressure Waves ◽

Autonomic Nervous

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Gastrointestinal transit and prolonged ambulatory colonic motility in health and faecal incontinence

Gut ◽

10.1136/gut.41.3.381 ◽

1997 ◽

Vol 41 (3) ◽

pp. 381-389 ◽

Cited By ~ 101

Author(s):

F Herbst ◽

M A Kamm ◽

G P Morris ◽

K Britton ◽

J Woloszko ◽

...

Keyword(s):

High Pressure ◽

Anal Sphincter ◽

Faecal Incontinence ◽

Urge Incontinence ◽

Colonic Motility ◽

Rhythmic Activity ◽

High Amplitude ◽

Left Colon ◽

Pressure Waves ◽

Colonic Motor

Background—Colonic motor function has not been studied in the ambulatory setting over a prolonged period in the unprepared state. Furthermore, the disturbance of this function in patients with faecal incontinence is unknown.Aim—To study colonic function over two to three days in the ambulatory, unprepared state in health and in patients with idiopathic faecal incontinence.Methods—Six healthy women and six women with faecal incontinence and a structurally intact anal sphincter ingested a dual radioisotope meal, and had a six sensor, solid state manometric probe colonoscopically inserted into the left colon. Scanning was performed until radioisotope left the gut and pressure was recorded for a median of 44 hours.Results—Three of six patients showed abnormal gastric emptying. Patients showed no disturbance of colonic radioisotope transit. Controls had a median of 12, whereas patients had a median of 16, high amplitude propagated waves per 24 hours. In three patients urge incontinence was associated with high amplitude (up to 500 cm water) propagated waves which often reached the rectum. These high pressure waves were identical to those occuring in healthy subjects, the only difference being the lack of adequate sphincter response. Passive incontinence was not associated with colonic motor activity. Defaecation in all subjects was associated with identical propagated waves, and distal movement of 13% (median) of right colonic content and excretion of 32% from the left colon and rectum. The urge to defaecate was associated with either propagated waves (45%) or non-propagated contractions (55%). Rectal motor complexes were recorded in both groups of subjects, but similar rhythmic activity was also recorded in the sigmoid and descending colon.Conclusions—Normal colonic function consists of frequent high pressure propagated waves. Rhythmic activity occurs both proximal to and in the rectum. Defaecation is characterised by high pressure propagated waves associated with coordinated anal sphincter relaxation. Patients with faecal incontinence may have a widespread disturbance of gut function. Urge incontinence, an urge to defaecate, and defaecation can all be associated with identical high amplitude propagated pressure waves.

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Exogenous glucagon-like peptide 1 reduces contractions in human colon circular muscle

Journal of Endocrinology ◽

10.1530/joe-13-0525 ◽

2014 ◽

Vol 221 (1) ◽

pp. 29-37 ◽

Cited By ~ 24

Author(s):

Antonella Amato ◽

Sara Baldassano ◽

Rosa Liotta ◽

Rosa Serio ◽

Flavia Mulè

Keyword(s):

Colonic Motility ◽

Circular Muscle ◽

Human Colon ◽

Inhibitory Effect ◽

Mechanical Activity ◽

Organ Bath ◽

Dependent Manner ◽

Double Labeling ◽

Glucagon Like Peptide ◽

Glucagon Like Peptide 1

Glucagon-like peptide 1 (GLP1) is a naturally occurring peptide secreted by intestinal L-cells. Though its primary function is to serve as an incretin, GLP1 reduces gastrointestinal motility. However, only a handful of animal studies have specifically evaluated the influence of GLP1 on colonic motility. Consequently, the aims of this study were to investigate the effects induced by exogenous GLP1, to analyze the mechanism of action, and to verify the presence of GLP1 receptors (GLP1Rs) in human colon circular muscular strips. Organ bath technique, RT-PCR, western blotting, and immunofluorescence were used. In human colon, exogenous GLP1 reduced, in a concentration-dependent manner, the amplitude of the spontaneous contractions without affecting the frequency and the resting basal tone. This inhibitory effect was significantly reduced by exendin (9–39), a GLP1R antagonist, which per se significantly increased the spontaneous mechanical activity. Moreover, it was abolished by tetrodotoxin, a neural blocker, or Nω-nitro-l-arginine – a blocker of neuronal nitric oxide synthase (nNOS). The biomolecular analysis revealed a genic and protein expression of the GLP1R in the human colon. The double-labeling experiments with anti-neurofilament or anti-nNOS showed, for the first time, that immunoreactivity for the GLP1R was expressed in nitrergic neurons of the myenteric plexus. In conclusion, the results of this study suggest that GLP1R is expressed in the human colon and, once activated by exogenous GLP1, mediates an inhibitory effect on large intestine motility through NO neural release.

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Oral ingestion of a 5-HT4 receptor agonist evokes a CNS-ENS mediated gastro-colonic reflex involving High Amplitude Propulsive Contractions (HAPCs) in the human colon within 5minutes

Autonomic Neuroscience ◽

10.1016/j.autneu.2015.07.029 ◽

2015 ◽

Vol 192 ◽

pp. 62

Author(s):

J.-H. Chen ◽

W.-L. Chen ◽

Y.-J. Yu ◽

Z.-X. Yang ◽

W.-Z. Yu ◽

...

Keyword(s):

Receptor Agonist ◽

Human Colon ◽

High Amplitude ◽

Oral Ingestion

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Haustral boundary contractions in the proximal 3-taeniated rabbit colon

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.00171.2015 ◽

2016 ◽

Vol 310 (3) ◽

pp. G181-G192 ◽

Cited By ~ 9

Author(s):

Ji-Hong Chen ◽

Zixian Yang ◽

Yuanjie Yu ◽

Jan D. Huizinga

Keyword(s):

Contractile Activity ◽

Motor Pattern ◽

Distal Colon ◽

Human Colon ◽

Proximal Colon ◽

Motor Patterns ◽

Video Recordings ◽

Induced Folding ◽

Phase Amplitude ◽

Cells Of Cajal

The rabbit proximal colon is similar in structure to the human colon. Our objective was to study interactions of different rhythmic motor patterns focusing on haustral boundary contractions, which create the haustra, using spatiotemporal mapping of video recordings. Haustral boundary contractions were seen as highly rhythmic circumferential ring contractions that propagated slowly across the proximal colon, preferentially but not exclusively in the anal direction, at ∼0.5 cycles per minute; they were abolished by nerve conduction blockers. When multiple haustral boundary contractions propagated in the opposite direction, they annihilated each other upon encounter. Ripples, myogenic propagating ring contractions at ∼9 cycles per min, induced folding and unfolding of haustral muscle folds, creating an anarchic appearance of contractile activity, with different patterns in the three intertaenial regions. Two features of ripple activity were prominent: frequent changes in propagation direction and the occurrence of dislocations showing a frequency gradient with the highest intrinsic frequency in the distal colon. The haustral boundary contractions showed an on/off/on/off pattern at the ripple frequency, and the contraction amplitude at any point of the colon showed waxing and waning. The haustral boundary contractions are therefore shaped by interaction of two pacemaker activities hypothesized to occur through phase-amplitude coupling of pacemaker activities from interstitial cells of Cajal of the myenteric plexus and of the submuscular plexus. Video evidence shows the unique role haustral folds play in shaping contractile activity within the haustra. Muscarinic agents not only enhance the force of contraction, they can eliminate one and at the same time induce another neurally dependent motor pattern.

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Effects of intraduodenal glucose infusion on gastric myoelectrical activity and antropyloroduodenal motility

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.1998.274.6.g1038 ◽

1998 ◽

Vol 274 (6) ◽

pp. G1038-G1044 ◽

Cited By ~ 3

Author(s):

M. A. M. T. Verhagen ◽

M. Samsom ◽

A. J. P. M. Smout

Keyword(s):

Motor Activity ◽

Dominant Frequency ◽

Glucose Infusion ◽

Pressure Waves ◽

Gastric Myoelectrical Activity ◽

Myoelectrical Activity ◽

Motility Index ◽

Antral Motility ◽

Pyloric Tone ◽

Pyloric Motility

Intraduodenal nutrient infusions cause an inhibition of antral motility and an increase in pyloric motility. The involvement of gastric myoelectrical activity in this intestinogastric feedback was studied. Electrogastrography and antropyloroduodenal manometry were performed in 10 healthy volunteers. The effects of 20-min infusions of 25% glucose (4 kcal/min) and saline were compared. Intraduodenal glucose infusions caused a decrease in the power of the dominant frequency in the electrogastrogram ( P = 0.028), but the frequency itself remained unchanged. The total number of dysrhythmias increased ( P = 0.035). An inhibition of antral motor activity ( P = 0.001), an increase in the number of isolated pyloric pressure waves ( P = 0.027), and an increase in basal pyloric tone ( P = 0.001) were simultaneously recorded. The change in power during glucose infusion correlated positively with the change in the antral motility index ( rs= 0.50, P = 0.001). It is concluded that inhibition of gastric myoelectrical activity is one of the mechanisms underlying an inhibition of motor activity in the gastric antrum.

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