Figure 5
Decreased motility associated with high sympathetic tone and high sympathetic reactivity in patient #7 (A–E), and patient #12 (F–J). Sympathetic tone and reactivity are reflected by the sympathetic index SI or SI/RSA. (A) Patient #7 had dominant simultaneous pressure waves in response to the meal which was associated with very high sympathetic reactivity. (B) Rectal bisacodyl evoked a normal sacral autonomic reflex: descending colon HAPWs with a normal coloanal reflex, (C) this patient showed high SI tone and reactivity during the active standing test prior to HRCM, and (D) a decrease in SI reactivity in response to bisacodyl compared to the meal. (E) An increase in HAPWs occurred in response to rectal bisacodyl. (F) Patient #12 had a complete absence of HAPWs but SPWs were evoked during baseline when the autonomic balance (SI/RSA) was normal. (G) No SPWs occurred in response to rectal bisacodyl. (H) This patient showed normal sympathetic tone and reactivity assessed by the active standing test. (I) and (J) The decrease in SPWs in response to the meal and rectal bisacodyl was associated with high SI/RSA. The gastrocolic and the sacral autonomic reflex did not occur. The white lines represent a gap of 10 cm where a balloon was attached to the catheter.
