Alterations in colonic motility and relationship to pain in colonic diverticulosis.
OBJECTIVE
Although the pathophysiologic basis of colonic diverticular disease is understood incompletely, there is agreement that abnormal colon motility probably plays a major role. However, several different abnormalities have been reported in such patients. The purpose of this study was to assess whether patients with diverticulosis display an abnormal duration of regular colonic contractile patterns, which has been observed in other conditions characterized by spasticity of the viscus, such as the irritable bowel syndrome.


METHODS
Twelve patients with symptomatic uncomplicated diverticular disease entered the study and underwent 24-hour colonic manometric recordings using a standard technique. The duration of regular contractile patterns was compared with that recorded in 20 healthy volunteers.


RESULTS
Patients with diverticulosis had a significant increase of the duration of regular patterns of phasic pressure activity compared with healthy controls (31% vs. 6.4%, P < .001). In both groups, the 2- or 3-cycles-per-minute activity represented more than 80% of such activity, especially in the sigmoid colon. More than 30% of patients, but none of the controls, reported episodes of abdominal pain (cramping lower abdominal pain with characteristics similar to those experienced at home) during the occurrence of a regular colonic contractile pattern. This was significant by symptom association probability criteria.


CONCLUSIONS
Patients with symptomatic uncomplicated colonic diverticulosis displayed increased duration of rhythmic, low-frequency, contractile activity, particularly in the segments bearing diverticula. These regular rhythms are associated significantly with reporting of abdominal pain.
Bassotti
Gabrio
G
Gastroenterology and Hepatology Section, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy. gabassot@tin.it
Battaglia
Edda
E
De Roberto
Giuseppe
G
Morelli
Antonio
A
Tonini
Marcello
M
Villanacci
Vincenzo
V
D015746:Abdominal Pain / Q000209:etiology* / Q000503:physiopathology; D000328:Adult; D000368:Aged; D003106:Colon / Q000503:physiopathology; D004241:Diverticulum, Colon / Q000150:complications* / Q000503:physiopathology*; D005260:Female; D005769:Gastrointestinal Motility / Q000502:physiology; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged