Faecal sensor to understand how signalling and muscle dynamics alter with incontinence

A series of funds enabled University of Brighton researchers to develop novel sensor devices for monitoring muscle dynamics within the bowel.

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. 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, researchers showed, 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, researchers focused on the development of novel sensor devices that could 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 the teams developed the first sensor that could 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 showed the importance of mucosal signalling mechanisms to influence the function of the bowel. A further funded study through IMPRESS Plus, aimed to develop a sensor-based device that could 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 was hoped that such a device in the future would 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.

As a result of this project further funding was received to undertake a visit to Professor Mawe’s laboratory (University of Vermont, USA) to use the sensing devices to understand how serotonin signalling and rectum motility are altered in inflammatory bowel disorders (IBD). As many as three in four people with IBD have had some experience of incontinence. Often, this is linked to flare-ups, but for about one in ten, incontinence occurs whether their disease is active or not. Therefore, the team gained insight into the relationship between inflammatory disorders and incontinence.