Ambulatory manometry and pH-metry were performed on 10 asymptomatic patients who had undergone lower oesophageal replacement with the left hemicolon between two and 20 years previously. Recording of the ambient pH in the intrathoracic colon was carried out simultaneously. In every patient the recording, which lasted approximately eight hours, included upright, supine, prandial, and post-prandial periods. The results were analysed both visually and by computer. The emerging motility patterns showed three basic types of wave, based on amplitudes--low amplitude contractions (LAC) measuring < 60 mm Hg, medium amplitude contractions (MAC) of 60-100 mm Hg, and high amplitude contractions (HAC) of 100-200 mm Hg. Additional subtypes were identified in the LACs and MACs. Using software primarily designed for oesophageal motility, the proportion of propulsive (6%-55%) waves could be distinguished from simultaneous or mixed waves, or both. A proportion of propulsive waves was noted in patients who had undergone surgery 10 or more years previously. It is concluded that the transposed colon retains its normal motility pattern but some adaptation to its new location may occur in the long term.
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