Myoelectric and motor patterns of continent pouch and conventional ileostomy

Our aim was to compare the myoelectrical and motor properties of the continent ileal pouch of 19 patients with those of the terminal ileum of six patients with Brooke ileostomy. The undistended ileum in both types of ileostomy exhibited pacesetter potentials at a mean frequency of 9.1 cycles per minute during fasting upon which were superimposed the cyclic bursts of action potentials and attendant contractions characteristic of the interdigestive state. Both types of ileostomy also accommodated to distention, with intraluminal pressure being kept low as the ileum filled. However, the amplitudes of the changes in intraluminal pressure present in the pouch were less than those present in the Brooke ileum both before and during distention, and the volumes to which the ileum could be distended were far greater in the patients with ileal pouches than in those with the Brooke ileostomy. Feeding did not alter the responses to distention of either type of ileostomy. We conclude that the electrical and motor patterns of the undistended ileum are similar in both types of ileostomy, but that the anatomic and motor properties of the pouch allow it to accept far larger intraluminal volumes both during fasting and after feeding.