From the Guidelines
The gastrocolic reflex is a physiological response that stimulates bowel movements after eating a meal.
Key Points
- This reflex is utilized in the management of constipation, where stimulant laxatives such as bisacodyl or glycerol suppositories are administered 30 minutes after a meal to synergize with the gastrocolic response 1.
- The gastrocolic reflex is an important consideration in the medical management of constipation, as it can be leveraged to improve bowel habits and reduce symptoms.
- The use of this reflex in conjunction with osmotic agents, such as polyethylene glycol or milk of magnesia, can be an effective strategy for managing constipation, with approximate daily costs of $1 or less 1.
- The gastrocolic response is a natural process that can be harnessed to improve symptoms in patients with defecatory disorders, highlighting the importance of considering the timing of meals and bowel movements in the management of these conditions.
From the Research
Definition of Gastrocolic Reflex
- The gastrocolic reflex is a physiologic increase in motor activity of the colon that occurs within minutes following meal ingestion 2.
- It is a response of the colon to the presence of food in the stomach 3.
- The reflex is mediated by the vagal nerve and neurohumoral mechanisms 2.
Triggers and Mechanisms
- Several triggers can provoke the gastrocolic reflex, including gastric dilation, caloric intake, and fat component of the meal 2.
- The response can be modified by several pharmacological factors 2.
- Novel sensory triggers for the gastrocolic reflex have been recently recognized 2.
Clinical and Diagnostic Features
- Assessment of the gastrocolic reflex is part of high-resolution colonic manometry studies, performed in patients with suspected colonic dysmotility 2.
- Abnormal gastrocolic reflex is a marker of an underlying pathology, which can provide a potential target for treatment 2.
- The gastrocolic reflex has a role in patients with constipation, diabetes, dumping syndrome, bowel hyper and hypomotility, and irritable bowel syndrome 2.
Observations and Implications
- In healthy infants and toddlers, a bowel movement is often observed within the first hour after a meal, with 75% of children having a bowel movement within this time frame 3.
- The gastrocolic reflex can be used as a facilitating factor to help a child defecate on the potty, 15-30 minutes after a meal 3.
- Patients with fecal incontinence associated with severe urgency may have rectal hypersensitivity and a more global colonic motility problem similar to irritable bowel syndrome 4.
- The recto-colonic inhibitory reflex is impaired in patients with irritable bowel syndrome, particularly under postprandial conditions 5.
- In adults with type 1 diabetes, the gastrocolic reflex is delayed and diminished, and further associated with the presence of neuropathy and constipation 6.