Abstract
From the point of view of its motor activity, the human colon is probably the least understood of the abdominal hollow viscera. This is due to several facts: a) its proximal portions are relatively inaccessible due to anatomical reasons; b) there is no reliable animal model due to the considerable anatomic-physiological differences among mammals. For instance, most deductions about human colonic motor activity have been drawn from experiences in cats and dogs, in which the colon displays a cecum which is almost atrophic, and the viscus is featureless and C-shaped, without the haustrations and the sharp angulations seen in man [1], c) the wide fluctuations of motility in the daily time course of the same individual makes the interpretation of many studies difficult [2, 3, 4], especially considering the fact that, until recently, most of the studies on human colonic motility have been conducted for relatively short (30–180 min) recording periods [5]. Recently, however, techniques that allow recording from the proximal portions of the human colon have been developed, and prolonged (24 h or more) observations of myoelectrical and contractile events have been achieved, thus improving our knowledge of the normal physiologic properties of the viscus [6, 7]. These informations have furthermore been integrated and confirmed by scintigraphic techniques (less invasive), that allow the measurement of intracolonic flow activity [8, 9]. The purpose of the present paper is to review the physiological aspects of colonic motility in man, quoting animal studies where human ones are lacking. We will briefly introduce some basic concepts, then a more detailed description of the main topic will follow.
Résumé
Le côlon humain est probablement le viscère creux de l'abdomen dont on connaît le moins l'activité motrice. Ceci résults de plusieurs facteurs: a) la partie proximale est relativement inaccessible pour des raisons anatomiques; b) il n'y a pas de modèle animal fiable en raison des différences anatomo-physiologiques considérables qui existent chez les mammifères. Par example, la plupart des déductions quant à l'activité motrice du côlon humain, résultent d'expériences chez les chats et les chiens dont le côlon présente un caecum le plus souvent atrophique et dont l'aspect est sans particularité, en forme de C, sans les haustrations et les angulations aiguës que l'on observe chez l'homme; c) les grandes fluctuations que l'on observe dans la motilité d'un même individu au cours d'une journée rendent difficiles l'interprétation de nombreuses études, particulièrement si l'on considère le fait que, jusqu'à une date récente, la plupart des études menées chez l'homme sur la motilité colique, comportaient des enregistrements sur des périodes relativement courtes (30 à 180 min). Récement, toutefois, des techniques permenttant des enregistrements de la partie proximale du côlon humain ont été développées autorisant des observations prolongées (24 h et plus) de l'activité myoélectrique et contractile permettant d'améliorer nos connaissances des propriétés physiologiques normales de cet organe. Ces données ont été intégrées par ailleurs et confirmées par des techniques scintigraphiques moins invasives permettant des mesures des flux intra-coliques. Le but de l'article présent est de faire une revue des aspects physiologiques de la motilité colique chez l'homme tout en citant les études animales lorsque des études identiques font défaut chez l'homme. Nous introduirons brièvement quelques concepts de base puis une description plus détaillée du sujet principal.
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Bassotti, G., Germani, U. & Morelli, A. Human colonic motility: physiological aspects. Int J Colorect Dis 10, 173–180 (1995). https://doi.org/10.1007/BF00298543
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DOI: https://doi.org/10.1007/BF00298543