The proximal colonic motor response to rectal mechanical and chemical stimulation
The proximal colonic motor response to rectal mechanical and chemical stimulation
复制标题
DOI：
10.1152/ajpgi.00194.2001
复制
发表时间：
2002-03-01
影响因子：
4.5
通讯作者：
Cook, IJ
中科院分区：
文献类型：
--
作者：
Bampton, PA;Dinning, PG;Cook, IJ
我们的目的是确定直肠扩张和/或胆汁酸输注是否刺激未准备的近端结肠的繁殖或非繁殖活动，在10名健康志愿者中使用鼻结肠测压导管（16个记录位置，间隔7.5 cm）。通过球囊膨胀和直肠灌注鹅去氧胆酸来评估直肠扩张后的感觉阈值和结肠近端运动反应。经直肠鹅去氧胆酸处理后，最大耐受球囊体积和刺激排便欲望的体积均显著降低（P < 0.01）。结肠传播压力波序列的频率在初始球囊充气后显著降低（P < 0.05），但在随后的鹅去氧胆酸输注后频率增加了一倍（P < 0.002）。非繁殖活性在气球充气后下降，不受酸注入的影响，并且对重复气球充气的反应进一步下降。我们得出的结论是，生理浓度的直肠鹅去氧胆酸是在结肠近端产生的压力波传播的有力刺激，并降低直肠感觉阈值。直肠膨胀抑制所有结肠运动活动。
We aimed to determine whether rectal distension and/or infusion of bile acids stimulates propagating or non-propagating 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.