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Novel sensory trigger for gastrocolonic response.

Lev Dorfman1, Anundorn Wongteerasut2, Khalil El-Chammas1,3

  • 1Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.

Neurogastroenterology and Motility
|January 10, 2023
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Sensory cues like seeing or smelling food can trigger the gastrocolonic response (GCR) in over half of patients. This suggests a new pathway for understanding and managing colonic motility disorders.

Keywords:
childcolonconstipationgastrocolonic reflexmanometry

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Area of Science:

  • Gastroenterology
  • Physiology
  • Neurogastroenterology

Background:

  • Gastrocolonic response (GCR) is a physiological increase in colon motor activity after eating, typically assessed via colonic manometry (CM).
  • GCR is a marker for normal colonic motor function.
  • The role of sensory stimuli in initiating GCR is not well understood.

Purpose of the Study:

  • To investigate if sensory stimulation (visual or olfactory) can induce GCR before food ingestion.
  • To characterize patients exhibiting a sensory-induced GCR.
  • To explore potential central pathways influencing colonic motility.

Main Methods:

  • Prospective study involving 89 patients with idiopathic constipation undergoing CM.
  • Sensory GCR defined as a ≥25% increase in motility index (MI) after sensory exposure, prior to eating.
  • Comparison of CM characteristics between patients with and without sensory GCR.

Main Results:

  • Over half (52.8%) of patients demonstrated a positive sensory GCR.
  • Patients with sensory GCR showed a higher rate of postprandial GCR (93.6% vs. 76.2%) and lower fasting MI.
  • Patients without postprandial GCR but with higher baseline MI were identified.

Conclusions:

  • Visual or olfactory food stimulation significantly increased baseline colonic motor activity in over 50% of patients.
  • Findings suggest a novel central sensory pathway can induce GCR.
  • This pathway may have clinical implications for diagnosing and managing colonic dysmotility.