Application Of Colonic Manometry In Ulcerative Colitis

objective: Ulcerative colitis(UC)is a chronic inflammatory disease that mainly affects the colon and rectum.Its clinical manifestations include diarrhea,mucous pus and blood stool,urgency of defecation,and tenesmus.UC assessment system including clinical symptom assessment,endoscopic mucosal involvement range and degree of inflammation,blood index appraisal,radiographic evaluation,etc.But the current evaluation is inconsistent with UC symptoms,may be abnormal colonic motility is an important factor,so the colonic dynamic examination has important significance.With the development of manometry for the rectum and the whole colon,they can be used to evaluate the dynamic function of the UC.In this study,manometry were used to assess changes in rectal and colonic pressure in patients with UC.To explore the relationship between resting pressure and disease course and gender by anorectal manometry,and the safety,feasibility and clinical value of colonic manometry in patients with UC.To further explore the correlation between the expression of LCA and S-100 and colon dynamic abnormality,and to lay a preliminary foundation for exploring the mechanism of UC colon dynamic abnormality.Methods: 1.Anorectal manometry:regard 26 patients in general hospital of tianjin medical university digestive department as the research object,these patients were given analrectal pressure measurement.Then relevant data were collected and rectal dynamic indicators were recorded: resting pressure,based on zero-line amplitude,and the resting pressure and zero-line amplitude of patients of different course of disease and different gender were compared.2.Colonic manometry:the UC patients who were treated in general hospital of tianjin medical university digestive department received total colonic pressure measurement,combined with colonoscopy,to collect relevant data of the patients,and record the dynamic indicators of the patients’ colon:high-amplitude propulsive contraction,lowamplitude propulsive contraction,and average pressure,to evaluate the patients’ colonic motility function.3.Specimens of total colectomy were obtained from UC patients,and H&E staining and immunohistochemical staining were performed on colon tissue specimens in stages.Results: 1.Anal-rectal manometry revealed 26 patients with UC,including 18 males and 8 females,with an average age of(48.04 ± 17.16)years and an average course of disease of(3.65 ± 1.85)years.2.There was no significant difference in age and course of disease between the two groups(T =-0.357,P=0.724;T =0.052,P=0.959);There was no significant difference between the two groups of resting pressure and the amplitude based on zero line(Z=-0.250,P=0.802).Z=-0.139,P=0.890).Grouped by course of disease,there was no significant difference between the two groups in resting pressure and amplitude based on zero line(Z=-0.077,P=0.938).Z=0.000,P=1.000).3.In this case of UC,low-amplitude propulsive contraction and segall isolated contraction were observed throughout the colon.The average contraction frequency of low-amplitude propulsive contraction was about 28 times,and the average amplitude was 25 mm Hg.A few contractions were observed occasionally,most of which were from sigmoid colon to descending colon.A total of 25 high-amplitude progressive contractions were found with an average amplitude of 25 mm Hg,and most of them were initiated from the ascending colon to the transverse colon,spleen and descending colon.Continuous conduction to the proximal sigmoid colon and gradual disappearance of the distal sigmoid colon to the rectum no high amplitude contraction.4.The microscopic lesions in patients with UC in the transverse colon,sacculations of colon disappear,when the microscopic is grade Ⅳ,the colonic average pressure is 57.7 mm Hg pressure;Grade III under descending colonoscopy,with an average pressure of 44.5mm Hg;Grade II under sigmoidoscopy,the mean pressure was 0mm Hg.The patient was graded grade II under rectal mucosa microscopy but the average rectal pressure was 5.16 mm Hg.5.There was no significant difference in the expression of LCA and S-100 in each colonic segment of UC.Conclusion: 1.In anorectal pressure measurement,there was no significant correlation between anorectal resting pressure and disease course or gender in UC patients.2.It is safe and feasible for patients with UC to undergo whole-colon pressure measurement.3.In patients with UC,the inflammation level in different parts of the colon was positively correlated with the pressure in that part.4.There was no correlation between the expression of LCA and S-100 and abnormal colonic motility.