Intestinal manometry: who needs it?

Abstract

The use of manometry, i.e. the recording of pressures within hollow viscera, after being successfully applied to the study of esophageal and anorectal motor dysfunctions, has also been used to investigate physiological and pathological conditions of the small bowel. By means of this technique, it has been possible to understand better the normal motor functions of the small intestine, and their relationship and variations following physiologic events, such as food ingestion. Moreover, intestinal manometry has proved useful to document motor abnormalities of the small bowel, although recognition of altered patterns specific for a determinate pathologic condition is still unavailable. However, this technique often permits the detection of abnormal gut motility in patients with abdominal symptoms such as unexplained vomiting and diarrhea, and it is sometimes also useful to address therapeutic targeting.

Keywords: Intestinal; Manometry; Motility; Myopathy; Neuropathy.

Figure 1

Antroduodenojejunal manometric recording in a healthy subject. A. During fasting, the three phases of the MMC are clearly identifiable; it is worth noting that the phase III is directed aborally from the antrum (first tracing) to the-jejunum (last tracing). B. After ingestion of a meal, a strong activation of contractile activity may be observed in all segments

Figure 2

A. Manometric recording of a myopathic pattern. It is worth noting that the phase III of MMC features very low amplitude contractions (arrow). B. Manometric recording of a neuropathic pattern, featuring normal amplitude but uncoordinated (simultaneous) activity fronts and a sustained nonpropagated burst of activity in the last tracing (arrow