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Am J Physiol Gastrointest Liver Physiol 282: G443-G449, 2002. First published October 24, 2001; doi:10.1152/ajpgi.00194.2001
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Vol. 282, Issue 3, G443-G449, March 2002

The proximal colonic motor response to rectal mechanical and chemical stimulation

P. A. Bampton1, P. G. Dinning1, M. L. Kennedy2, D. Z. Lubowski2, and I. J. Cook1

Departments of 1 Gastroenterology and 2 Colorectal Surgery, The St. George Hospital, University of New South Wales, Sydney, Australia 2217

We aimed to determine whether rectal distension and/or infusion of bile acids stimulates propagating or nonpropagating activity in the unprepared proximal colon in 10 healthy volunteers using a nasocolonic manometric catheter (16 recording sites at 7.5-cm spacing). Sensory thresholds and proximal colonic motor responses were assessed following rectal distension by balloon inflation and rectal instillation of chenodeoxycholic acid. Maximum tolerated balloon volume and the volume that stimulated a desire to defecate were both significantly (P < 0.01) reduced after rectal chenodeoxycholic acid. The frequency of colonic propagating pressure wave sequences decreased significantly in response to initial balloon inflations (P < 0.05), but the frequency doubled after subsequent chenodeoxycholic acid infusion (P < 0.002). Nonpropagating activity decreased after balloon inflation, was not influenced by acid infusion, and demonstrated a further decrease in response to repeat balloon inflation. We concluded that rectal chenodeoxycholic acid in physiological concentrations is a potent stimulus for propagating pressure waves arising in the proximal colon and reduces rectal sensory thresholds. Rectal distension inhibits all colonic motor activity.

chenodeoxycholic acid; colon; manometry; peristalsis; afferent





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