Measurement of Muscular Activity Associated With Peristalsis in the Human Gut Using Fiber Bragg Grating Arrays

Author version made available under Publisher copyright policy.Diagnostic catheters based on fibre Bragg gratings (FBG’s) are proving to be highly effective for measurement of the muscular activity associated with peristalsis in the human gut. The primary muscular contractions that generate peristalsis are circumferential in nature; however, it has long been known that there is also a component of longitudinal contractility present, acting in harmony with the circumferential component to improve the overall efficiency of material movement. We report on the development of, and latest results from, catheter based sensors capable of detecting both forms of muscular activity. While detection of the circumferential contractions has been possible using solid state, hydraulic, and pneumatic sensor arrays in the oesophagus and anorectum, FBG based devices allow access into the complex and convoluted regions of the gut below the stomach. We report early results from FBG catheters used during trials of novel therapies in patients with both slow transit constipation and faecal incontinence. In addition, there have been relatively few reports on the measurement or inference of longitudinal contractions in humans. This is due to the lack of a viable recording technique suitable for real-time in-vivo measurement of this type of activity over extended lengths of the gut. We report preliminary data on the detection of longitudinal motion in lengths of excised mammalian colon using an FBG technique that should be viable for similar detection in humans. The longitudinal sensors have been combined with pressure sensing elements to form a composite catheter that allows the relative phase between the two components to be detected. The output of both types of catheter has been validated using digital video mapping in an ex-vivo animal preparation using lengths of rabbit ileum

The effect of luminal content and rate of occlusion on the interpretation of colonic manometry

This is the accepted version of the following article: [Arkwright, J. W., Dickson, A., Maunder, S. A., Blenman, N. G., Lim, J., O’Grady, G., Archer, R., Costa, M., Spencer, N. J., Brookes, S., Pullan, A. and Dinning, P. G. (2013), The effect of luminal content and rate of occlusion on the interpretation of colonic manometry. Neurogastroenterology & Motility, 25: e52–e59.], which has been published in final form at [http://dx.doi.org/10.1111/nmo.12051]. In addition, authors may also transmit, print and share copies with colleagues, provided that there is no systematic distribution of the submitted version, e.g. posting on a listserve, network or automated delivery.Background Manometry is commonly used for diagnosis of esophageal and anorectal motility disorders. In the colon, manometry is a useful tool, but clinical application remains uncertain. This uncertainty is partly based on the belief that manometry cannot reliably detect non-occluding colonic contractions and, therefore, cannot identify reliable markers of dysmotility. This study tests the ability of manometry to record pressure signals in response to non-lumen-occluding changes in diameter, at different rates of wall movement and with content of different viscosities. Methods A numerical model was built to investigate pressure changes caused by localized, non-lumen-occluding reductions in diameter, similar to those caused by contraction of the gut wall. A mechanical model, consisting of a sealed pressure vessel which could produce localized reductions in luminal diameter, was used to validate the model using luminal segments formed from; (i) natural latex; and (ii) sections of rabbit proximal colon. Fluids with viscosities ranging from 1 to 6800 mPa s-1 and luminal contraction rates over the range 5-20 mmHg s-1 were studied. Key Results Manometry recorded non-occluding reductions in diameter, provided that they occurred with sufficiently viscous content. The measured signal was linearly dependent on the rate of reduction in luminal diameter and also increased with increasing viscosity of content (R2 = 0.62 and 0.96 for 880 and 1760 mPa s-1, respectively). Conclusions & Inferences Manometry reliably registers non-occluding contractions in the presence of viscous content, and is therefore a viable tool for measuring colonic motility. Interpretation of colonic manometric data, and definitions based on manometric results, must consider the viscosity of luminal content.Australian National Health & Medical Research Counci

Measurement of the longitudinal and circumferential muscular activity associated with peristalsis using a single fibre grating array

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