Article
Gastroenterology & Hepatology
Claudio Morera, Samuel Nurko, Leonel Rodriguez
Summary: The study evaluated the utility of motility studies in pediatric functional constipation, finding that patients with fecal incontinence had higher frequency of normal motility parameters than those without, but overall interpretation was not different. Colonic manometry helped predict therapy response in functional constipation without fecal incontinence, while anorectal manometry showed no added benefit in the evaluation of functional constipation with/without fecal incontinence.
JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION
(2021)
Article
Multidisciplinary Sciences
Nicholas Baidoo, Ellie Crawley, Charles H. Knowles, Gareth J. Sanger, Abi Belai
Summary: Ageing alters the total collagen content and distribution in the human colon, with a significant increase in total collagen content in the submucosa and muscularis externa of the elderly. These changes may lead to a loss of function.
Review
Gastroenterology & Hepatology
Jan D. Huizinga, Amer Hussain, Ji-Hong Chen
Summary: High-resolution manometry has significantly enhanced our understanding of human colonic motility and the autonomic reflexes involved in generating motor patterns. Studies have shown abnormal or reduced interstitial cells of Cajal (ICC) in cases of colonic motor dysfunction requiring surgery. However, there are still gaps in our knowledge about the specific role of ICC in controlling colonic motility and the mechanistic link between ICC abnormalities and colonic motor dysfunction.
AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY
(2021)
Article
Gastroenterology & Hepatology
Sushmitha Grama Srinivasan, Anjani Muthyala, Mayank Sharma, Kelly Feuerhak, Andrea Boon, Kent R. Bailey, Adil E. Bharucha
Summary: This study found three possibly interrelated abnormalities in DD, including aberrant activation of abdominal muscles during squeeze in DD, dyscoordination of abdominal muscles during various tasks in constipated women, and abdomino-anal dyscoordination.
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
(2022)
Article
Gastroenterology & Hepatology
Leonel Rodriguez, Kitzia Colliard, Samuel Nurko, Alejandro Flores, Terry L. Buchmiller
Summary: Diverting ostomy and colon manometry are effective interventions for pediatric functional constipation, improving symptoms and guiding the timing of ostomy closure.
JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION
(2022)
Article
Pediatrics
Shimon E. Jacobs, Laura Tiusaba, Elizaveta Bokova, Teresa L. Russell, Tamador Al-Shamaileh, Christina Feng, Andrea T. Badillo, Anil Darbari, Marc A. Levitt
Summary: This study proposes a standardized approach for managing refractory constipation in children, including contrast enema, anorectal manometry, and exclusion of Hirschsprung disease. Colonic motility assessment may be needed for patients without Hirschsprung disease or anal sphincter problems. Most patients responded well to antegrade flushes, avoiding the need for colonic resection.
JOURNAL OF PEDIATRIC SURGERY
(2023)
Article
Medicine, General & Internal
Tal David Berger, Karina Lukovits, David Cavanaugh, Samuel Nurko, Keira Mason
Summary: Anorectal manometry is a common gastrointestinal motility study in children and plays an important role in diagnosing Hirschsprung disease. However, this procedure can be uncomfortable and painful for children. The only available options for sedation are nitrous oxide or midazolam, and their effect on manometry readings is unclear. This study aimed to investigate the effect of Dexmedetomidine (DEX) on anorectal function in children. The results showed that DEX may alter the measurements of anorectal function, which is crucial for diagnosing gastrointestinal medical conditions.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Gastroenterology & Hepatology
George Triadafilopoulos, Megan Lee, Leila Neshatian
Summary: This study assessed the relative utility of the London classification in the decision-making of patients with chronic constipation (CC) by comparing wireless motility capsule (WMC) and high-resolution anorectal manometry (HR-ARM) results. It was found that anorectal dysfunction had a high prevalence in patients with slow colonic transit time (CTT) regardless of the classification criteria. Therefore, the specificity and utility of WMC and HR-ARM in assessing patients with CC need further investigation.
DIGESTIVE DISEASES AND SCIENCES
(2023)
Article
Gastroenterology & Hepatology
Desiree F. Baaleman, Mana H. Vriesman, Marc A. Benninga, Neetu Bali, Karla H. Vaz, Desale Yacob, Carlo Di Lorenzo, Peter L. Lu, Ilan J. N. Koppen
Summary: This study aimed to evaluate the clinical utility and tolerability of the new 3D-ARM catheter in children with constipation. The results showed that although the 3D-ARM provided more detailed visualization, it caused more discomfort compared to HR-ARM and resulted in inconsistent visualization of the recto-anal inhibitory reflex.
NEUROGASTROENTEROLOGY AND MOTILITY
(2022)
Article
Gastroenterology & Hepatology
David O. Prichard, Jeffrey R. Fetzer
Summary: This study found that there are significant differences in results obtained by different operators during high-resolution anorectal manometry (HRM), despite using similar instructions. These differences may have a significant impact on the diagnoses and therapies offered to constipated patients.
NEUROGASTROENTEROLOGY AND MOTILITY
(2022)
Article
Medicine, General & Internal
Fei Li, Meifeng Wang, Syed Hameed Ali Shah, Ya Jiang, Lin Lin, Ting Yu, Yurong Tang
Summary: This study reviewed the reports of 257 adult patients with functional constipation, finding that 89 patients had rectoanal areflexia (RA) and 168 patients had rectoanal inhibitory reflex impairment (RAIR). Compared with the RAIR group, patients in the RA group showed more severe constipation symptoms, higher levels of physical discomfort, and a higher prevalence of inadequate relaxation of the anal sphincter. The proportion of patients using laxatives and the combination of laxatives was significantly higher in the RA group, while the efficacy of biofeedback therapy was significantly lower.
Article
Medicine, General & Internal
Richard Leibbrandt, Samuel Nurko, S. Mark Scott, Phil G. Dinning
Summary: This study analyzed combined antroduodenal and colonic manometry traces in pediatric patients and found that most colonic simultaneous pressure waves (SPWs) appeared to span the entire digestive tract, suggesting that they may be an artefact caused by factors outside the colon. The authors suggest that SPWs should not form part of any diagnostic criteria in pediatric studies.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Obstetrics & Gynecology
Yan Yin, Yumin Zhang, Cheng Qian
Summary: This study aimed to investigate the association between delivery mode and the number of pregnancies with anorectal manometry data in patients with postpartum constipation. The findings showed no significant differences in manometry parameters between the two groups. However, patients with a spontaneous delivery had a lower change in maximal contracting sphincter pressure compared with those with a Cesarean section, indicating that Cesarean may preserve better push function during defecation.
BMC PREGNANCY AND CHILDBIRTH
(2023)
Article
Medicine, General & Internal
Samuel Tanner, Ahson Chaudhry, Navneet Goraya, Rohan Badlani, Asad Jehangir, Dariush Shahsavari, Zubair Malik, Henry P. Parkman
Summary: In patients with chronic constipation, about 22% have dyssynergic defecation (DD), about 55% have slow transit constipation (STC), and 13% have both DD and STC. There were no specific symptoms differentiating STC from DD, but patients with STC and DD reported more severe constipation symptoms.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Gastroenterology & Hepatology
Nayna A. Lodhia, Laura Horton, Thapa Namisha, Alison H. Goldin, Walter W. Chan
Summary: This retrospective cohort study analyzed the relationship between recent opioid use in constipated patients and anorectal sensation, defecatory function, and balloon expulsion. Results showed that recent opioid use was associated with anorectal dysfunction and difficulty in passing stools.
DIGESTIVE DISEASES AND SCIENCES
(2022)
Article
Gastroenterology & Hepatology
Paul T. Heitmann, Reizal Mohd Rosli, Lyn Maslen, Lukasz Wiklendt, Raghu Kumar, Taher I. Omari, David Wattchow, Marcello Costa, Simon J. Brookes, Phil G. Dinning
Summary: This study utilized high-resolution impedance manometry to investigate colonic motor patterns and gas transit in healthy volunteers. Results showed an increase in the prevalence of the 2-8/minute cyclic motor pattern and propagation of impedance events after a meal or gas insufflation. The temporal association between propagating contractions and gas transit supports the hypothesis that the 2-8/minute cyclic motor pattern acts as a physiological brake modulating rectal filling.
NEUROGASTROENTEROLOGY AND MOTILITY
(2022)
Review
Gastroenterology & Hepatology
Hannah M. E. Evans-Barns, Justina B. Swannjo, Misel Trajanovska, Mark Safe, John M. Hutson, Phil G. Dinning, Sebastian K. King
Summary: The systematic review focused on post-operative anorectal manometry in children with Hirschsprung disease, revealing a lack of high-quality evidence and consistency in reported outcomes. Standardization of protocols, cohort reporting, and outcome assessments are essential for future research in this area.
NEUROGASTROENTEROLOGY AND MOTILITY
(2022)
Article
Gastroenterology & Hepatology
Paul F. Vollebregt, Lukasz Wiklendt, Rebecca E. Burgell, Pam Chaichanavichkij, Phil G. Dinning, Charles H. Knowles, S. Mark Scott
Summary: This study aimed to investigate the perception of urge to defecate in patients with chronic constipation. The results showed that 50% of the patients had abnormal urge perception, and they were more likely to describe the urge as abdominal sensation, suggesting that sensory dysfunction plays an important role in the pathophysiology of constipation.
AMERICAN JOURNAL OF GASTROENTEROLOGY
(2022)
Article
Gastroenterology & Hepatology
Timothy J. Hibberd, Marcello Costa, David J. Smolilo, Lauren J. Keightley, Simon J. Brookes, Phil G. Dinning, Nick J. Spencer
Summary: Colonic motor complexes (CMCs) are the main neurogenic activity that initiates propulsion in the guinea pig distal colon. In this study, it was found that CMCs, evoked by an intraluminal pellet, could be restored during nicotinic receptor blockade by pharmacological agents that directly or indirectly enhance the excitability of intrinsic primary afferent neurons (IPANs). IPANs are the only enteric neurons in the colon that contain calcitonin gene-related peptide (CGRP). Blocking CGRP receptors decreased the frequency of CMCs, implicating their role in CMC initiation. These results support the involvement of IPANs in the initiation of CMCs.
AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY
(2022)
Review
Surgery
David A. Wattchow, David Smolilo, Tim Hibberd, Nick J. Spencer, Simon J. H. Brookes, Roberto De Giorgio, Paul T. Heitmann, Marcello Costa, Phil G. Dinning
Summary: This article discusses the advantages and opportunities for surgeons and basic scientists to conduct research on the nervous system of the intestines. It highlights the translation of findings from animal studies to human subjects, which has greatly expanded our knowledge of the human enteric nervous system. These findings have led to therapeutic trials for gastrointestinal disorders.
ANZ JOURNAL OF SURGERY
(2022)
Article
Neurosciences
Dominic R. Parker, Lukasz Wiklendt, Adam Humenick, Bao Nan Chen, Tiong Cheng Sia, David A. Wattchow, Phil G. Dinning, Simon J. H. Brookes
Summary: This study found that sympathetic axons in the myenteric plexus preferentially target cholinergic excitatory cells over nitrergic neurons, which likely plays a role in the inhibitory modulation of human colonic motility by the sympathetic nervous system.
FRONTIERS IN NEUROSCIENCE
(2022)
Letter
Gastroenterology & Hepatology
Paul F. Vollebregt, Phil G. Dinning, Charles H. Knowles, S. Mark Scott
UNITED EUROPEAN GASTROENTEROLOGY JOURNAL
(2022)
Article
Gastroenterology & Hepatology
Taher Omari, Charles Cock, Peter Wu, Michal Marcin Szczesniak, Mistyka Schar, Jan Tack, Nathalie Rommel
Summary: This study aimed to establish a methodology for diagnosing oropharyngeal disorders using P-HRM-I. The results showed that UES relaxation pressure was the best indicator for differentiating patients from controls and diagnosing UES disorders. A diagnostic scheme was also devised to identify patients with UES disorder or propulsive disorder. Additionally, the study found that patients with pharyngeal pressurizations and evidence of reduced UES relaxation and/or distensibility had higher aspiration scores.
NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Article
Physiology
Stephanie K. Gaskell, Rebecca Burgell, Lukasz Wiklendt, Phil G. Dinning, Ricardo J. S. Costa
Summary: The study aimed to determine the impact of exercise duration on gastrointestinal functional responses and symptoms. It found that exercise is associated with changes in gastric myoelectrical activity, leading to a reduction in gastric motility and slower gastric transit time. This may explain the high incidence and severity of exercise-associated gastrointestinal symptoms.
JOURNAL OF APPLIED PHYSIOLOGY
(2023)
Article
Gastroenterology & Hepatology
Wai Ping Yew, Adam Humenick, Bao Nan Chen, David A. Wattchow, Marcello Costa, Phil G. Dinning, Simon J. H. Brookes
Summary: Ex vivo intracellular recordings and dye fills, combined with immunohistochemistry, are used to analyze the enteric nervous system of laboratory animals. Treatment with a collagenase/neutral protease mix improves recording success and reduces damage. Most dye-filled myenteric neurons are uni-axonal, and there is a low correlation between morphology and electrophysiology. Neurons immunoreactive for nitric oxide synthase are more excitable and distinctive grooves on the neuron surface may represent preferential sites of synaptic inputs.
NEUROGASTROENTEROLOGY AND MOTILITY
(2023)
Article
Physiology
David J. J. Smolilo, Timothy J. J. Hibberd, Marcello Costa, Phil G. G. Dinning, Lauren J. J. Keightley, Dayan De Fontgalland, David A. Wattchow, Nick J. J. Spencer
Summary: The speed of pellet propulsion in the isolated guinea pig distal colon in vitro is higher than in vivo measurements, suggesting inhibitory mechanisms from outside the gut. The study aimed to investigate the effects of sympathetic nerve stimulation on different motor behaviors of the distal colon. Results showed that electrical stimulation of colonic nerves inhibited transient neural events (TNEs) and pellet propulsion, while significant inhibition of colonic motor complexes (CMCs) required higher frequencies of stimulation. The findings suggest differential sensitivities to sympathetic input among distinct neurogenic motor behaviors of the colon and raise the possibility of paradoxical effects of CMCs on pellet movement suppression in vivo.
PHYSIOLOGICAL REPORTS
(2023)
Review
Medicine, General & Internal
Hannah M. E. Evans-Barns, Melissa Y. Tien, Misel Trajanovska, Mark Safe, John M. Hutson, Phil G. Dinning, Sebastian K. King
Summary: Despite surgical correction, long-term bowel dysfunction can occur in children with anorectal malformations, including fecal incontinence and evacuation disorders. Anorectal manometry is commonly used to assess anorectal function in this population, but there is a lack of standardized protocols and interpretation. This systematic review evaluated existing data on anorectal manometry results in children following anorectal malformation repair and highlighted the need for standardized protocols to enhance comparability and clinical relevance.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Pediatrics
Hannah M. E. Evans-Barns, Liesel Porrett, Penelope L. Hartmann, Jessica Taranto, Suzie Jackson-Fleurus, Phil G. Dinning, John M. Hutson, Warwick J. Teague, Sebastian K. King
Summary: This study evaluated the findings and completeness of screening after the implementation of standardized protocols. The results showed that complete screening can accurately diagnose associated anomalies in patients with anorectal malformation. Compared with previous data, the proportion of complete screening significantly increased after the implementation of standardized protocols.
JOURNAL OF PEDIATRIC SURGERY
(2023)
Proceedings Paper
Gastroenterology & Hepatology
John Dent, Phil G. Dinning
Summary: This chapter examines the role of luminal chemoreceptors in modulating gastro-pyloro-duodenal motor function, particularly in controlling the emptying of nutrients into the small intestine. The vagus nerve and intramural nerves are both involved in controlling gastric relaxation and antral contractions during duodenal chemoreceptor activation. In addition, localized pyloric contractions prevent the flow of nutrients through the pylorus, mediated by ascending duodenal intramural nerve pathways. The duodenal brake motor mechanism is likely signaled by descending intramural duodenal nerves. The intrinsic intramural pathways play a crucial role in the early stages of digestion.
ENTERIC NERVOUS SYSTEM II
(2022)
Proceedings Paper
Gastroenterology & Hepatology
Phil G. Dinning
Summary: The colon plays a crucial role in bacterial fermentation, fluid and fatty acid exchange, and waste elimination. Understanding the colonic motor patterns is essential for studying various colonic disorders. However, the knowledge about normal colonic response is still limited.
ENTERIC NERVOUS SYSTEM II
(2022)