Control of human colonic motor function

Human colonic motility is governed by control mechanisms involving the electrical activity of the smooth muscle cell membranes, the intrinsic and extrinsic nervous activity, and hormonal action. The structural bases for neural and myogenic control have not been demonstrated. However, gap junctions are lacking between muscle cells, and nerves are not close to smooth muscle cells. The myogenic control, as observed in vitro, is described and compared with results obtained from different in vivo techniques. In vitro and in vivo measurements are critically evaluated, and a reconciliation between them attempted. No appropriate animal model is available to help resolve different findings and interpretations. Neural control of colon motility is exerted probably through modulation of myogenic activity as well as directly. The activities of extrinsic nerves, intrinsic motor nerves and afferent nerves are integrated within the colon, at prevertebral ganglia and in the spinal cord in animals, but similar data are not available for the human. There is a lack of studies directly relating transit to motility and conventional beliefs need reexamination.