Effect of morphine, prostigmine, pethidine, and probanthine on the human colon in diverticulosis studied by intraluminal pressure recording and cineradiography

EDITORIAL SYNOPSIS A previous study has shown that morphine causes the generation of high intrasigmoid pressures. In diverticulosis of the colon, this effect is exaggerated in those segments actually bearing diverticula. There is therefore a prima facie case for questioning the wisdom of giving morphine to patients with diverticulosis. In the present investigation, cineradiography was used in conjunction with intraluminal pressure recording to study the behaviour of colonic diverticula after the administration of morphine and other drugs. High intrasigmoid pressures evoked by morphine are shown to be accompanied by distension of neighbouring diverticula, sometimes to an extrelne degree. Although the necks of the diverticula may shut under the influence of morphine, they do not remain closed but open intermittently and allow colonic contents to be squirted into the diverticula. It appears possible that the use of morphine in acute diverticulitis may predispose to rupture of inflamed diverticula. These effects of morphine can be abolished by an intravenous injection of the anticholinergic agent, probanthine. The analgesic drug, pethidine (demerol), does not have the undesirable effects of morphine and it is suggested that this drug is to be preferred to morphine for the relief of pain in acute diverticulitis. RESULTS Figure 1 consists of a pressure tracing together with on July 21, 2023 by guest.