Colonic regular contractile frequency patterns in irritable bowel syndrome: the 'spastic colon' revisited.

摘要

BACKGROUND: Irritable bowel syndrome is a frequent gastrointestinal disorder of which the pathophysiological basis is still not completely understood. Among the various proposed mechanisms, colonic motility may play a role, at least in a subset of patients. AIMS: To investigate the regular colonic contractile patterns in patients with irritable bowel syndrome. Our working hypothesis was that an increase of these patterns in such condition might represent a motility equivalent of the so-called 'spastic colon'. PATIENTS AND METHODS: Twelve patients of both genders were investigated by means of 24 h colonic manometry, and the results were compared to those from 20 healthy controls. Regular contractile patterns (with frequencies ranging from 2 to 8 per min) were calculated for the entire recording period and in single colonic segments. RESULTS: Overall, colonic frequency patterns were significantly more frequent in patients than controls (12.6% vs 6.4% of the total contractile activity, P < 0.001); in bothgroups, the 3 cycles/min frequency was predominant, especially in the sigmoid colon. More than 40% patients displayed a correlation between abdominal pain and occurrence of regular contractile frequencies. CONCLUSIONS: Abnormal colonic motility may play some role in the pathogenesis of symptoms related to irritable bowel syndrome, with an excess of regular contractile activity related to the so-called 'spastic colon'.