An expert's guide to classical manometric patterns seen in high-resolution colonic manometry.

Introduction: High-resolution colonic manometry is a research and diagnostic tool used to evaluate colonic motility. Used in health it helps us understand normal colonic motility and the colonic response to physiological stimuli such as meal, as well as chemical (laxatives) and mechanical (distension) stimuli. In pediatric and adult patients with suspected colonic disorders, it can help to understand the abnormal colonic motility associated with the condition.

Area covered: High-resolution manometric catheters contain multiple closely spaced sensors that detect intraluminal pressure changes and contractile force, which can be interpreted as contractile activity. This activity forms several distinctive motor patterns that help in understanding normal colonic physiology and provide insights into the potential pathophysiology underlying colonic disorders such as constipation. After a PubMed search of colonic high-resolution manometry studies, this review provides an overview of the characterized motor patterns, when they occur, how they are initiated, their clinical relevance, and their role, if any, in guiding therapeutic interventions.

Expert opinion: High-resolution colonic manometry has identified motor patterns that were missed or mislabeled by low-resolution recordings. How best to use this information to guide treatment remains to be determined.