We have previously demonstrated that the major propulsive motor pattern in the rabbit colon, the colonic motor complex, manifests itself in different motor pattern configurations depending on the level of excitation of the colon. In the rabbit, intraluminal prucalopride, in a dose dependent manner, evoked several motor patterns starting with fast propagating contractions (45) that result in simultaneous pressure waves (39) to the most forceful propulsive contraction, the Long Distance Contraction (LDC), that results in high-amplitude propagating pressure waves (39), similar to the HAPW reported here. The rabbit study and the present study suggest that SPWs and HAPWs are part of the repertoire of propulsive activities in the human colon and that the SPWs are generally evoked at lower levels of excitation.
The HAPW is an essential component of the process of defecation and patients with constipation tend to have fewer HAPWs (16) (4, 40) (23). Reduction in occurrence of HAPWs can be accompanied by a decreased frequency of urge to defecate (34). Consistently, some patients with diarrhea-predominant irritable bowel syndrome (IBS-D) have been observed to generate more HAPWs compared with healthy subjects (25). Data reported here, indicate that luminal prucalopride can act as an effective prokinetic. Its effect appears to be similar to that of oral prucalopride (13).