Skip to main content
SpringerLink
Log in

Colonic Physiology

  • Chapter
  • First Online:
The ASCRS Textbook of Colon and Rectal Surgery

  • 3829 Accesses

Abstract

Awareness of normal colonic physiology is paramount to understanding the pathophysiology and successful treatment of colon and rectal diseases. The primary functions of the colon include absorption of water and electrolytes, further metabolism of ingested foods, secretion of electrolytes and mucous, recycling of nutrients, storage of semisolid matter, and propulsion of fecal material toward the rectum. Extensive research is underway involving the gut microbiome and its role in normal physiology as well as in colonic diseases.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Hurst AF. An address on the sins and sorrows of the colon. Delivered before the harrogate medical society on November 26, 1921. Br Med J. 1922;1(3207):941–3.

    CAS  PubMed  PubMed Central  Google Scholar 

  2. Bleier JIS, Wilkins KB. Colonic physiology. In: Beck DE, Roberts P, Saclarides T, Senagore A, Stamos M, Wexner SD, ed. The ASCRS textbook of colon and rectal surgery, 3rd ed. New York: Springer Science +Business LLC: 2016; pg 27–28.

    Google Scholar 

  3. Danowitz M, Solounias N. Embryology, comparative anatomy, and congenital malformations of the gastrointestinal tract. Edorium J Anat Embryo. 2016;3:39–50. (embryology figure).

    Google Scholar 

  4. Rose C, Parker A, Jefferson B, Cartmell E. The characterization of feces and urine; a review of the literature to inform advanced treatment technology. Crit Rev Environ Sci Technol. 2015;45:1827–79.

    CAS  PubMed  PubMed Central  Google Scholar 

  5. Phillips SF, Giller J. The contribution of the colon to electrolyte and water conservation in man. J Lab Clin Med. 1973;81:733–46.

    CAS  PubMed  Google Scholar 

  6. Cannon WB. The movements of the intestines studied by means of the Röentgen rays. Am J Phys. 1902;6:251–77.

    Google Scholar 

  7. Othman A, Al-Shboul. The importance of interstitial cells of cajal in the gastrointestinal tract. Saudi J Gastroenterol. 2013;19(1):3–15.

    Google Scholar 

  8. Sellers RS, Morton D. The colon: from banal to brilliant. Toxicol Pathol. 2014;42(1):67–81.

    PubMed  Google Scholar 

  9. Cox HM. Neuroendocrine peptide mechanisms controlling intestinal epithelial function. Current Opinion Pharmacol. 2016;31:50–6.

    CAS  Google Scholar 

  10. Johnson LR. Fluid and electrolyte absorption. In LR Johnson Ed, Gastrointestinal physiology, 9th ed. Elsevier 2019;121–125.

    Google Scholar 

  11. Gurney MA, Laubitz D, Ghishan FK, et al. Pathophysiology of intestinal Na+/H+ exchange. Cell Mol Gastroenterol Hepatol. 2017;3(1):27–40.

    PubMed  Google Scholar 

  12. Sandle GI. Pathogenesis of diarrhea in ulcerative colitis: new views on an old problem. J Clin Gastroenterol. 2005;39:S49–52.

    PubMed  Google Scholar 

  13. Kunzelmann K, Mall M. Electrolyte transport in the mammalian colon: mechanisms and implications for disease. Physiol Rev. 2002;82(1):245–89.

    CAS  PubMed  Google Scholar 

  14. Edmonds CJ. Absorption of sodium and water by human rectum measured by a dialysis method. Gut. 1971;12:356–62.

    CAS  PubMed  PubMed Central  Google Scholar 

  15. Singh SK, Binder HJ, Boron WF, et al. Fluid absorption in isolated perfused colonic crypts. J Clin Invest. 1995;96:2373–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  16. Bergman EN. Energy contributions of volatile fatty acids from the gastrointestinal tract in various species. Physiol Rev. 1990;70:567–90.

    CAS  PubMed  Google Scholar 

  17. Kiela PR, Ghishan FK. Na+/H+ exchange in mammalian digestive tract. In: Said HM, Ghishan FK, editors. Physiology of the gastrointestinal tract. 6th ed. London: Academic Press, Elselvier; 2018. p. 1273–316.

    Google Scholar 

  18. Bharucha AE, Brookes SJH. Neurophysiologic mechanisms of human large intestinal motility. In: Said HM, Ghishan FK, editors. Physiology of the gastrointestinal tract. 6th ed. London: Academic Press, Elselvier; 2018. p. 517–64.

    Google Scholar 

  19. Said HM. Intestinal absorption of vitamin K: cellular and molecular mechanisms. In: Said HM, editor. Physiology of the gastrointestinal tract. 6th ed. London: Academic Press, Eselvier; 2018. p. 1197–9.

    Google Scholar 

  20. Brookes SJ, Spencer NJ, Costa M, et al. Extrinsic primary afferent signaling in the gut. Nat Rev Gastroenterol Hepatol. 2013;10:286–96.

    CAS  PubMed  Google Scholar 

  21. Furness JB. Disorders of motility and secretion and therapeutic targets in the enteric nervous system. In: Furness, editor. The enteric nervous system. Oxford: Blackwell Publishing; 2006. p. 200–11.

    Google Scholar 

  22. Boeckxstaens G, Camilleri M, Sifrim D, et al. Fundamentals of neurogastroenterology: physiology/motility – sensation. Gastroenterology. 2016;150:1292–304.

    Google Scholar 

  23. Lomax AE, Sharkey KA, Furness JB. The participation of the sympathetic innervation of the gastrointestinal tract in disease states. Neurogastroenterol Motil. 2010;22:7–18.

    CAS  PubMed  Google Scholar 

  24. Knowles CH, Scott SM, Lunnis PJ. Slow transit constipation: a disorder of pelvic autonomic nerves? Dig Dis Sci. 2001;46:389–401.

    CAS  PubMed  Google Scholar 

  25. Keszthelyi D, Troost FJ, Masclee AA. Irritable bowel syndrome: methods, mechanisms, and pathophysiology. Methods to assess visceral hypersensitivity in irritable bowel syndrome. Am J Physiol Gastrointest Liver Physiol. 2012;303:G141–54.

    CAS  PubMed  Google Scholar 

  26. Ness TJ, Metcalf AM, Gebhart GF. A psychophysiological study in humans using phasic colonic distension as a noxious visceral stimulus. Pain. 1990;43:377–86.

    CAS  PubMed  Google Scholar 

  27. Azpiroz F, Bouin M, Camilleri M, et al. Mechanisms of hypersensitivity in IBS and functional disorders. Neurogastroenterol Motil. 2007;10:62–88.

    Google Scholar 

  28. Mertz H, Naliboff B, Munakata J, Niazi N, Mayer EA. Altered rectal perception is a biological marker of patients with irritable bowel syndrome. Gastroenterology. 1995;109:40–52.

    CAS  PubMed  Google Scholar 

  29. Mawe GM, Hoffman JM. Serotonin signaling in the gut-functions and therapeutic targets. Nat Rev Gastroenterol Hepatol. 2013;10:473–86.

    CAS  PubMed  PubMed Central  Google Scholar 

  30. Rao SS, Sadeghi P, Beaty J. Ambulatory 24-hour colonic manometry in slow-transit constipation. Am J Gastroenterol. 2004;99(12):2405–16.

    PubMed  Google Scholar 

  31. Furukawa Y, Cook IJ, Panagopoulos V, et al. Relationship between sleep patterns and human colonic motor patterns. Gastroenterology. 1994;107:1372–81.

    CAS  PubMed  Google Scholar 

  32. Bampton PA, Dinning PG, Kennedy ML, et al. Prolonged multi-point recording of colonic manometry in the unprepared human colon: providing insight into potentially relevant pressure wave parameters. Am J Gastroenterol. 2001;96:1838–48.

    CAS  PubMed  Google Scholar 

  33. Cremonini F, Delgado-Aros S, Camilleri M. Efficacy of alosetron in irritable bowel syndrome: a meta-analysis of randomized controlled trials. Neurogastroenterol Motil. 2003;15:79–86.

    CAS  PubMed  Google Scholar 

  34. Camilleri M. Is there an experimental basis for the development of ischaemic colitis as a result of the 5-HT3 antagonist treatment? Neurogastroenterol Motil. 2007;19:77–84.

    CAS  PubMed  Google Scholar 

  35. Ford A, Suares N. Effect of laxatives and pharmacological therapies in chronic idiopathic constipation: systematic review and meta-analysis. Gut. 2011;60:209–18.

    PubMed  Google Scholar 

  36. Bouras EP, Camilleri M, Burton DD, et al. Prucalopride accelerates gastrointestinal and colonic transit in patients with constipation without a rectal evacuation disorder. Gastroenterol. 2001;120:354–60.

    CAS  Google Scholar 

  37. Ao M, Venkatasubramanian J, Boonkaewwan C, et al. Lubiprostone activated Cl secretion via cAMP signaling and increases membrane CFTR in the human colon carcinoma cell line, T84. Dig Dis Sci. 2011;56:339–51.

    CAS  PubMed  Google Scholar 

  38. Sweetser S, Busciglio IA, Camilleri M, et al. Effect of a chloride channel activator, lubiprostone, on colonic sensory and motor functions in healthy subjects. Am J Physiol Gastrointest Liver Physiol. 2009;296:G295–301.

    CAS  PubMed  Google Scholar 

  39. Schey R, Rao SSC. Lubiprostone for the treatment of adults with constipation and irritable bowel syndrome. Dig Dis Sci. 2011;56:1619–25. Motility in physiology of the gastrointestinal tract. 6th Ed. Elsevier; 2018, pp 517–64.

    CAS  PubMed  Google Scholar 

  40. Manabe N, Cremonini F, Camilleri M, et al. Effects of bisacodyl on ascending colon emptying and overall colonic transit in healthy volunteers. Ailment Pharmacol Ther. 2009;30:930–6.

    CAS  Google Scholar 

  41. Ewe K, Holker B. The effect of a diphenolic laxative (Bisacodyl) on water and electrolyte transport in the human colon (author’s transl). Klin Wochenschr. 1974;52:827–33.

    CAS  PubMed  Google Scholar 

  42. Kamm MA, Dudding TC, Melenhorst J, et al. Sacral nerve stimulation for intractable constipation. Gut. 2010;59:33–40.

    Google Scholar 

  43. Dinning PG, Fuentealba SE, Kennedy ML, et al. Sacral nerve stimulation induces pan-colonic propagating pressure waves and increases defecation frequency in patients with slow-transit constipation. Color Dis. 2007;9:123–32.

    CAS  Google Scholar 

  44. Garner CE, Smith S, de Lacy CB, et al. Volatile organic compounds from feces and their potential for diagnosis of gastrointestinal disease. FASEB J. 2007;21:1675–88.

    CAS  PubMed  Google Scholar 

  45. Spohn SN, Young VB. Gastrointestinal microbial ecology with perspectives on health and disease. In: Physiology of the gastrointestinal tract. 6th ed: Elsevier; 2018. p. 737–53.

    Google Scholar 

  46. Ahmed I, Greenwood R, Costello BL, et al. An investigation of fecal volatile organic metabolites in irritable bowel syndrome. PLoS One. 2013;8:e58204.

    PubMed  PubMed Central  Google Scholar 

  47. Nyangale EP, Mottram DS, Gibson GR. Gut microbial activity, implications for health and disease: the potential role of metabolite analysis. J Proteome Res. 2012;11:5573–85.

    CAS  PubMed  Google Scholar 

  48. Adams JB, Johansen LJ, Powell LD, et al. Gastrointestinal flora and gastrointestinal status in children with autism-comparisons to typical children and correlation with autism severity. BMC Gastroenterol. 2011;11:22.

    PubMed  PubMed Central  Google Scholar 

  49. Imhann F, Vich Vila A, Bonder MJ, et al. Interplay of host genetics and gut microbiota underlying the onset and clinical presentation of inflammatory bowel disease. Gut. 2018;67:108–19.

    CAS  PubMed  Google Scholar 

  50. Nitzan O, Elias M, Peretz A, et al. Role of antibiotics for treatment of inflammatory bowel disease. World J Gastroenterol. 2016;22:1078–87.

    CAS  PubMed  PubMed Central  Google Scholar 

  51. Peterson J, Garges S, Giovanni M, et al. The NIH human microbiome project. Genome Res. 2009;19:2317–23.

    PubMed  PubMed Central  Google Scholar 

  52. Proctor LM. The human microbiome project in 2011 and beyond. Cell Host Microbe. 2011;10:287–91.

    CAS  PubMed  Google Scholar 

  53. Gevers D, Knight R, Petrosino JF, et al. The human microbiome project: a community resource for the healthy human microbiome. PLoS Biol. 2012;10(8):e1001377.

    CAS  PubMed  PubMed Central  Google Scholar 

  54. Human Microbiome Project Consortium. Structure, function and diversity of the healthy human microbiome. Nature. 2012;486(7402):207–14.

    Google Scholar 

  55. Human Microbiome Project Consortium. A framework for human microbiome research. Nature. 2012;486:215–21.

    Google Scholar 

  56. Integrative HMP (iHMP) Research Network Consortium. The Integrative Human Microbiome Project: dynamic analysis of microbiome-host omics profiles during periods of human health and disease. Cell Host Microbe. 2014;16(3):276–89.

    Google Scholar 

  57. Bouchie A. White house unveils National Microbiome Initiative. Nat Biotechnol. 2016;34(6):580.

    CAS  PubMed  Google Scholar 

  58. Ley RE, Peterson DA, Gordon JI. Ecological and evolutionary forces shaping microbial diversity in the human intestine. Cell. 2006;124(4):837–48.

    CAS  PubMed  Google Scholar 

  59. Sullivan A, Edlund C, Nord NE. Effect of antimicrobial agents on the ecological balance of human microflora. Lancet Infect Dis. 2001;1(2):101–14.

    CAS  PubMed  Google Scholar 

  60. De La Cochetiere MF, Durand T, Lalande V, et al. Effect of antibiotic therapy on human fecal microbiota and the relation to the development of. Microb Ecol. 2008;56:395–402.

    CAS  PubMed  Google Scholar 

  61. Dethlefsen L, Huse S, Sogin ML, et al. The pervasive effects of an antibiotic on the human gut microbiota, as revealed by deep 16S rRNA sequencing. PLoS Biol. 2008;6:2383–400.

    CAS  Google Scholar 

  62. Modi SR, Collins JJ, Relman DA. Antibiotics and the gut microbiota. J Clin Invest. 2014;124:4212–8.

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of Southern California – Keck School of Medicine, Department of Surgery, Division of Colorectal Surgery, Los Angeles, CA, USA

    Glenn T. Ault

  2. Associate Dean for Graduate Medical Education, Des Moines University Medicine and Health Sciences, Des Moines, IA, USA

    Jennifer S. Beaty

Authors
  1. Glenn T. Ault
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jennifer S. Beaty
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Glenn T. Ault .

Editor information

Editors and Affiliations

  1. Department of Colorectal Surgery, Cleveland Clinic, Cleveland, OH, USA

    Scott R. Steele

  2. Department of Colorectal Surgery, Cleveland Clinic, Cleveland, OH, USA

    Tracy L. Hull

  3. University of Chicago Medical Center, Chicago, IL, USA

    Neil Hyman

  4. Department of Surgery, University of Massachusetts Medical School, Worcester, MA, USA

    Justin A. Maykel

  5. Division of Gastrointestinal Surgery, University of Florida, Gainesville, FL, USA

    Thomas E. Read

  6. Department of Colon and Rectal Surgery, Ochsner Clinic, New Orleans, LA, USA

    Charles B. Whitlow

Rights and permissions

Reprints and permissions

Copyright information

© 2022 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Ault, G.T., Beaty, J.S. (2022). Colonic Physiology. In: Steele, S.R., Hull, T.L., Hyman, N., Maykel, J.A., Read, T.E., Whitlow, C.B. (eds) The ASCRS Textbook of Colon and Rectal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-66049-9_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-66049-9_2

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-66048-2

  • Online ISBN: 978-3-030-66049-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation