Colonic motility investigation by modern techniques: time to ‘reclaim’ the value of physiology?

Abstract

I read with interest the recent article of Wilkinson-Smith and colleagues on the assessment of colonic motility by means of MRI and high-resolution colonic manometry (HRCM),1 showing that patients with constipation and irritable bowel syndrome (IBS) may display some abnormalities when such investigated. I would like to make some observations on this study. Since HRCM probes were positioned 35 cm from the anal verge, I would be very cautious in claiming that those were ‘colonic’ studies, since (by considering the physiological bending of the large bowel) at the very best only a very limited colonic area was studied. Indeed, the authors in the methods reported that only the sigmoid colon was actually investigated in a systematic …