The incidence of chronic constipation and faecal impaction increases with age. The treatment of these conditions is challenging for both the patient and clinicians and living with these conditions results in a reduced quality of life which may lead to a loss of independence. Our work has focused on understanding how bowel function changes with age and to develop devices that can be utilised to identify such changes in order to better manage these conditions.
Using BBSRC funding, we have recently shown, using a mouse model, that ageing is associated with a reduction in colonic motility, a decrease in faecal pellet output and faecal pellet water content. These changes were not due to a loss of myenteric neurons, but were associated with an increase in mucosal TNF-α, a pro-inflammatory mediator and alterations in mucosal serotonin signalling. Treatment of mice for two weeks with the anti-TNF-α drug etanercept reversed the changes in serotonin signalling, increased pellet output and water content to levels that were indistinguishable from young controls.
Using ESPRC funding, we have focused on the development of novel sensor devices that can be used to monitor these important mucosal signalling molecules. Mucosal serotonin has been shown to play a key role in directing muscle dynamics within the bowel and therefore we developed the first sensor that can be used to simultaneously monitor mucosal serotonin signalling and colonic motility. This device demonstrated that mucosal serotonin was released to trigger muscle contraction in order to drive faecal propulsion.
Such studies show the importance of mucosal signalling mechanisms to influence the function of the bowel. Therefore, our current funding study through IMPRESS Plus, aims to develop a sensor-based device that can be utilised to understand the link between signalling and muscle dynamics of the rectum and internal anal sphincter to understand normal and impaired defecation. It is hoped that such as device in the future can be utilised as a novel technological tool in understanding the efficacy of therapeutic management of incontinence patients in order to enhance the patient’s quality of life by providing optimised therapy.