A pilot study of motility and tone of the left colon in patients with diarrhea due to functional disorders and dysautonomia

Objective: Our aim was to identify qualitative or quantitative colonic motor patterns induced postprandially in a pilot study of patients with diarrhea due to functional disease or dysautonomia to identify objective endpoints for future studies. Methods: In patients with functional diarrhea (n = 5) or dysautonomia (n = 4) in whom GI transit was documented by scintigraphy, we studied colonic motility by combined manometry and barostat measurements for I h fasting and 2 h postprandially (1000-kcal meal). Data were compared with those of healthy control subjects. Results: There were no differences in compliance, overall phasic motility of the left colon, fasting tone, or maximal change in postprandial tone in the diarrhea group as compared with the control group. The diarrhea group showed more high amplitude propagated contractions 4.4 ± 3.6 (SD)/2 h, p < 0.05) compared with the control group (0.7 ± 1.4/2 h); the mean postprandial tonic response (12 ± 14%, p < 0.05) and its duration were reduced in the diarrhea group compared with the control group (27 ± 17%). Two dysautonomic patients showed a paradoxical relaxation of the colon postprandially. Conclusion: Reduced duration of increased colonic tone postprandially and increased number of high amplitude propagated contractions seem to be useful objective endpoints for future studies.