aDepartment of Medicine bDivision of Gastroenterology and Hepatology, Houston Methodist Hospital, Houston, Texas, USA.
Curr Opin Gastroenterol. 2014 Jan;30(1):75-83. doi: 10.1097/MOG.0000000000000028.
To critically evaluate recent advances in the anatomy and physiology of colorectal motility and sensation and to discuss their potential clinical implications.
Relatively noninvasive methods for the assessment of colonic transit have been developed and validated and high-resolution colonic and anorectal manometry as well as the barostat, despite their technical challenges, are beginning to show promise in clinical practice. At a more basic level, the importance of interstitial cells of Cajal as pacemakers, neuromodulators and stretch receptors has been revealed and their dysfunction associated with a number of disease states. Although the impact of a variety of biologically active agents on colonic sensorineural function in vitro has been described, the clinical implications of most of these effects remain unknown at this time. As the molecular bases of colonic motor and sensory function are identified, new disease entities are being described and novel therapeutic targets revealed. Equally important is the growing recognition of luminal factors and of the colonic microbiota, in particular, in the generation and modulation of colonic motility and sensation.
The complexities of the basic physiology of colorectal motility and sensation continue to be revealed and our understanding of their regulation has progressed; clinical implications remain at a preliminary stage. Progress has been made, however, in the clinical assessment of colonic motor function.
批判性评估结直肠运动和感觉的解剖学和生理学的最新进展，并讨论其潜在的临床意义。
评估结肠通过相对非侵入性的方法已经得到了发展和验证，尽管高分辨率结肠和肛门直肠测压以及测压法存在技术挑战，但它们在临床实践中开始显示出前景。在更基本的层面上，Cajal 间质细胞作为起搏器、神经调节剂和拉伸感受器的重要性已经被揭示，它们的功能障碍与许多疾病状态有关。尽管已经描述了多种生物活性物质对结肠感觉神经功能的体外影响，但目前大多数这些影响的临床意义尚不清楚。随着结直肠运动和感觉功能的分子基础的确定，新的疾病实体正在被描述，新的治疗靶点也在被揭示。同样重要的是，人们越来越认识到腔内因素和结肠微生物群，特别是在结肠运动和感觉的产生和调节中的作用。
结直肠运动和感觉的基本生理学的复杂性不断被揭示，我们对其调节的理解也在不断发展；临床意义仍处于初步阶段。然而，在结肠运动功能的临床评估方面已经取得了进展。
