Colonic motor abnormalities in slow transit constipation defined by high resolution, fibre-optic manometry

Previous colonic manometry studies in patients with slow transit constipation have shown, when compared to health controls, a diminished frequency of high amplitude propagating sequences and an absent or diminished colonic motor response to physiological stimuli such as a meal or morning waking. Using high-resolution, fiber-optic manometry we provide a detailed examination of fasted and fed colonic motor patterns in this patient group. Our data indicate that throughout the colon of patients with slow transit constipation, slow wave activity at 2–6 cycles per minute is commonly recorded, however unlike healthy controls this activity does not synchronize and express coordinated cyclic propagating motor patterns in response to eating a high calorie meal. We propose a hypothesis that a possible neuropathy in the extrinsic parasympathetic inputs to the colon of patients with slow transit constipation may exist.