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Twenty-four hour recordings of colonic motility in patients with diverticular disease

Evidence for abnormal motility and propulsive activity

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

Abstract

INTRODUCTION: Diverticular disease of the colon is one of the most common pathologic entities in western countries. Although altered motility of the large bowel is commonly believed to be one of the major pathophysiologic mechanisms, no convincing evidence has been reported yet. In fact, only a few conflicting studies concerning distal colonic motility (with no information on forceful propulsive activity) are available in the literature. PURPOSE: The purpose of the present study was to investigate basal and stimulated (postprandial) colonic motility from the transverse (not affected), descending, and sigmoid colon in patients with diverticular disease, together with detection of high-amplitude propagated contractions (mass movements). Motility data from patients were compared with those obtained in healthy control subjects. METHODS: Ten patients and 16 control subjects of both sexes were recruited for the study. In all subjects, colonic motility was recorded for a 24-hour period by a colonoscopically positioned manometric catheter. Two 1000-kcal mixed meals were served during the study. RESULTS: Compared with control subjects, patients with diverticular disease displayed significantly increased amounts of motility in the affected segments; the response to a physiologic stimulus (meal) was also abnormal in the patients' group. Diverticular disease patients also had a significant increase of forceful propulsive activity compared with control subjects (average = 10.3±2.7/subject/day high-amplitude propagated contractions for patients and 5.5±0.8/subject/day for control subjects;P=0.051); interestingly, about 20 percent of such activity was abnormal, being propagated in a retrograde fashion. CONCLUSIONS: We concluded that patients with diverticular disease of the colon have abnormal motor and propulsive activities of the large bowel, which are confined to the affected segments.

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Authors and Affiliations

  1. Department of Surgery and Surgical Emergencies, University of Perugia Medical School, Perugia, Italy

    Maria A. Pelli M.D.

  2. Department of Internal Medicine and Therapeutics, University of Pavia Medical School, Pavia, Italy

    Marcello Tonini Ph.D.

  3. Clinica di Gastroenterologia ed Epatologia, Via Enrico Dal Pozzo, 06122, Perugia, Italy

    Gabrio Bassotti M.D., Ph.D. (F.A.C.G.), Edda Battaglia M.D. & Fabrizio Spinozzi M.D.

Authors
  1. Gabrio Bassotti M.D., Ph.D.
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  2. Edda Battaglia M.D.
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  3. Fabrizio Spinozzi M.D.
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  4. Maria A. Pelli M.D.
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  5. Marcello Tonini Ph.D.
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Additional information

During the period this study was performed, Dr. Battaglia was on leave from the Department of Clinical Pathophysiology, University of Torino Medical School.

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Bassotti, G., Battaglia, E., Spinozzi, F. et al. Twenty-four hour recordings of colonic motility in patients with diverticular disease. Dis Colon Rectum 44, 1814–1820 (2001). https://doi.org/10.1007/BF02234460

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