title: Sigmoid compliance and visceral perception in spinal cord injury patients.
abstract: Intestinal motor and sensory dysfunctions in traumatic complete or incomplete spinal cord injury (SCI) are frequent and result in altered mechanisms of defecation. The aim of this study is to investigate sigmoid compliance and perception in chronic SCI patients. Sigmoid responses to fixed-tension distentions were assessed using a tensostat in six patients (six men, 42 ± 4 years) with chronic complete transection of the spinal cord (high-SCI; five tetraplegic C5-C7 and one paraplegic T4-T6) and impaired evacuation (i.e. constipation). A group of 10 healthy individuals (six men, 25 ± 1 years) served as controls. SCI patients had higher sigmoid compliance at the highest distention level than the controls (10.3 ± 2.4 vs. 5.1 ± 0.8 ml/mmHg; P<0.05). Perception scores at first sensation were higher in SCI patients (2.3 ± 0.7 vs. 1.1 ± 0.1; P<0.05), but were not different at the highest distention levels (3.7 ± 0.8 vs. 3 ± 1; NS). The most commonly reported sensation by patients was distention/bloating and was referred less commonly to the hypogastrium compared with distention/bloating in controls. An increased sigmoid compliance can be detected in constipated SCI patients. The preservation of some degree of visceral sensations, although abnormally referred, could imply the occurrence of sensory input remodeling at the spinal level.
authors.affiliation: Department of Gastroenterology, Humanitas Clinical Institute IRCCS, Rozzano, Milan, Italy. beatrice.salvioli@humanitas.it
authors.forename: Beatrice
authors.initials: B
authors.lastname: Salvioli
authors.forename: Gabriele
authors.initials: G
authors.lastname: Bazzocchi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Barbara
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Stanghellini
authors.forename: Cesare
authors.initials: C
authors.lastname: Cremon
authors.forename: Mauro
authors.initials: M
authors.lastname: Menarini
authors.forename: Roberto
authors.initials: R
authors.lastname: Corinaldesi
authors.forename: Roberto
authors.initials: R
authors.lastname: De Giorgio
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002908:Chronic Disease; D012809:Colon, Sigmoid / Q000503:physiopathology*; D003187:Compliance / Q000502:physiology; D003248:Constipation / Q000209:etiology / Q000503:physiopathology; D003672:Defecation / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009473:Neuronal Plasticity / Q000502:physiology; D012684:Sensory Thresholds / Q000502:physiology; D013119:Spinal Cord Injuries / Q000150:complications / Q000503:physiopathology*; D055815:Young Adult