Rheology of human faeces and pathophysiology of defaecation.

BACKGROUND: Rectal evacuation involves multiple mechanisms that are not completely understood. The aim of this study was to quantify the rheologic property, i.e., yield stress, which governs the ease of deformation of a range of faeces of differing consistency and understand its influence on the pathophysiology of defaecation. METHODS: Yield stresses of faeces of differing consistencies and Bristol scores were determined by the Vane test. We then explored the effects of this property on ease of defecation using a simple static model of the recto-anal junction based on the laws of flow for yield stress pastes and checked the conclusions by X-ray defaecography experience. RESULTS: The yield stress of faeces increased exponentially with their solid content, from 20 to 8000 Pa. The static model of the recto-anal junction showed that evacuation of faeces of normal consistency and yield stress is possible with moderate dilatation of the anal canal, whilst the evacuation of faeces with higher yield stress requires greater dilatation of the anal canal. X-ray defaecography showed that such increases occurred in vivo. CONCLUSIONS: The diameter of the recto-anal junction is increased to enable the passage of feces with high yield stress. The finite limits to such dilation likely contribute to fecal impaction. Hence, difficulties in defaecation may result either from unduly high yield stress or pathologies of reflex recto-anal dilatation or a combination of the two.

Flow and mixing by small intestine villi.

Flow and mixing in the small intestine are multi-scale processes. Flows at the scale of the villi (finger-like structures of ≈500 µm length) are poorly understood. We developed a three-dimensional lattice-Boltzmann model to gain insight into the effects of villous movements and the rheology of digesta on flow, mixing and absorption of nutrients at the periphery of the intestinal lumen. Our model simulated the hydrodynamic consequences of villi movements that resulted from folding of the mucosa during longitudinal contractions. We found that cyclic approximation and separation of groups of villi generated laminar eddies at the edges of the group and augmented mass transfers in the radial direction between the inter-villous space and the intestinal lumen which improved the absorption of nutrients and mixing at the periphery of the lumen. This augmentation was greater with highly diffusible nutrients and with high levels of shear-thinning (pseudoplasticity) of the fluid. We compared our results with bulk flows simulations done by previous workers and concluded that villous movements during longitudinal contractions is a major radial mixing mechanism in the small intestine and increases mixing and absorption around the mucosa despite adverse rheology.

A review of mixing and propulsion of chyme in the small intestine: fresh insights from new methods.

The small intestine is a convoluted flexible tube of inconstant form and capacity through which chyme is propelled and mixed by varying patterns of contraction. These inconstancies have prevented quantitative comparisons of the manner in which contractile activity engenders mixing of contained chyme. Recent quantitative work based on spatiotemporal mapping of intestinal contractions, macro- and micro-rheology, particle image velocimetry and real-time modelling has provided new insights into this process. Evidence indicates that the speeds and patterns of the various types of small intestinal contraction are insufficient to secure optimal mixing and enzymatic digestion over a minimal length of intestine. Hence particulate substrates and soluble nutrients become dispersed along the length of the lumen. Mixing within the lumen is not turbulent but results from localised folding and kneading of the contents by contractions but is augmented by the inconstant spatial disposition of the contractions and their component contractile processes. The latter include inconstancies in the sites of commencement and the directions of propagation of contraction in component groups of smooth muscle cells and in the coordination of the radial and circular components of smooth muscle contraction. Evidence suggests there is ongoing augmentation of mixing at the periphery of the lumen, during both the post-prandial and inter-meal periods, to promote flow around and between adjacent villi. This results largely from folding of the relatively inelastic mucosa during repeated radial and longitudinal muscular contraction, causing chyme to be displaced by periodic crowding and separation of the tips of the relatively rigid villi. Further, micro-rheological studies indicate that such peripheral mixing may extend to the apices of enterocytes owing to discontinuities in the mobile mucus layer that covers the ileal mucosa.

Spatiotemporal organization of standing postprandial contractions in the distal ileum of the anesthetized pig.

BACKGROUND: Spatiotemporal (ST) mapping has mainly been applied to ex vivo preparations of the gut. We report the results of ST mapping of the spontaneous and remifentanil-induced motility of circular and longitudinal muscles of the distal ileum in the postprandial anaesthetized pig. METHODS: Spatiotemporal maps of strain rate were derived from image sequences of an exteriorized loop of ileum on a superfusion tray at laparotomy. Parameters were obtained by direct measurement from these maps, and by auto- and cross-correlation of map segments. KEY RESULTS: Localized domains of standing longitudinal and circular activity that alternated between neighboring domains occurred spontaneously and both were promptly extinguished following intraluminal dosage with lidocaine. Longitudinal or circular contractions within a domain typically occurred at times that would coincide with every second or third cycle of the slow wave but propagated within the domain at a rate consistent with that reported within spike patches. Shortly after intravenous administration of remifentanil, longitudinal and circular contractions at the reported slow wave frequency propagated over longer distances at a high speed before slowing to a rate similar to that reported for slow waves. CONCLUSIONS & INFERENCES: ST mapping based on cross-correlation is a robust tool for the analysis of intestinal movement and minimizing movement artefacts. We propose that the ST pattern of standing longitudinal and circular contractions arises from variation in the refractory period of smooth muscle, and hence, in its response to successive slow waves with neural stimuli influencing the former and having a mainly permissive role.

Spatiotemporal mapping of the muscular activity of the gizzard of the chicken (Gallus domesticus).

We report the results of spatiotemporal mapping of the spontaneous actions of component muscles of the gizzard and associated structures in ex vivo preparations with combined superfusion and vascular perfusion. Ongoing spontaneous contraction of cranial and caudal thin muscles occurred at a frequency of 2.2 ± 0.1 cycles per minute. Contractions of M. tenuis craniodorsalis with mean duration of 2.8 ± 0.2 s commenced ventrally adjacent to the distal limit of the proventriculus and progressed dorsally at 2.02 ± 0.03 mm•s(-1) in a concerted front. Near simultaneous contraction of M. tenuis caudoventralis of mean duration of contraction of 4.7 ± 0.7 s commenced dorsally and progressed ventrally at a similar rate (2.1 ± 0.1 mm•s(-1)) and in a similar manner. Contraction of the caudoventralis preceded that of craniodorsalis (mean 1.1 ± 0.15 s). Contraction of the 2 tenuis muscles was synchronous with the first component peak of the cyclic increase in lumen pressure and with distension of the crassus musculature. Contraction of the M. crassus caudodorsalis muscle coincided with the second component peak and was followed by distension of the tenuis musculature. The latter commenced before the relaxation of the tenuis muscles. Contractions of the crassus muscle propagated rapidly at right angles to the orientation of the muscle fibers at a faster velocity than that of the tenuis musculature. The durations of the component peaks in lumen pressure indicated that the duration of crassus contraction was similar to that of the tenuis musculature.

A comparison of the organization of longitudinal and circular contractions during pendular and segmental activity in the duodenum of the rat and guinea pig.

BACKGROUND: Little is known of the spatiotemporal organization of pendular duodenal contractions. METHODS: We used longitudinal and radial spatiotemporal mapping to examine and compare pendular and segmental contractile activity in the proximal duodenum of the rat and guinea pig when the lumen was perfused with saline or micellar decanoic acid. KEY RESULTS: Isolated phasic longitudinal contractions occurred along the rat duodenum with a frequency of 36 ± 2 cpm and strain rate amplitude of 26.8 ± 8.0% s(-1). These contractions occurred at fixed locations along the duodenum forming columns on the longitudinal strain rate map. The strain rate activity had local maxima at 4-6 points spaced at 7.7 ± 4.0 mm intervals along the duodenum and were uncoordinated between neighboring domains. Similarly disposed, less distinct, longitudinal contractions occurred in the guinea pig duodenum at a frequency of 25.2 ± 6.6 cpm with amplitude 6.8 ± 3.6% s(-1) but these were generally accompanied by numerous circular contractions that were distributed over 4-5 fixed locations and occurred with a frequency of 9 ± 3 cpm. Isolated static circular muscle contractions also occurred but at a lower rate in the rat than the guinea pig. Both types of contractions propagated after dosage with tetrodotoxin, lidocaine, atropine, or apamin. CONCLUSIONS & INFERENCES: Localized contractions during segmental and pendular activity had some features of the spike patches that are normally associated with slow wave propagation. However, the commencement of propagation following administration of neural blocking agents and cholinergic inhibitors indicates their localization is maintained by inhibitory elements of the enteric nervous system.

Mechanisms explaining the role of viscosity and post-deglutitive pharyngeal residue on in vivo aroma release: A combined experimental and modeling study.

The objective of this study was to analyse the viscosity effect of liquid Newtonian products on aroma release, taking human physiological characteristics into account. In vivo release of diacetyl from glucose syrup solutions varying widely in viscosity (from 0.7 to 405mPas) was assessed by five panelists using Proton Transfer Reaction Mass Spectrometry (PTR-MS). The physicochemical properties of the solutions and the physiological parameters of subjects were experimentally measured. In parallel, a mechanistic model describing aroma release while eating a liquid food was developed. Model predictions based on the characteristics of the glucose syrup solution were invalidated when compared to in vivo measurements. Therefore, the assumption that the post-deglutitive pharyngeal residue was considerably diluted with saliva was introduced into the model. Under this hypothesis, the model gives a satisfactory prediction of the in vivo data. Thus, relevant properties to be considered for in vivo release were those of product-saliva mixes.