Abstract
This study was done to understand the different available methods used to calculate colorectal transit times. A single abdominal radiograph is taken following six successive daily ingestions of the same number of identical radiopaque markers. This method correlates well (P < 0.001) with that using a single ingestion of markers with daily x-ray films until total expulsion. In techniques used to measure colorectal transit time with multiple ingestion of markers, the number of days of ingestion depends on the kinetics of marker defecation. This was found to differ markedly in various groups of control subjects and constipated patients (P < 0.001) and can be used to obtain reliable data, even in subjects with severe constipation. When they ingest 20 markers, constipated patients are found to retain eight or more markers three days after ingestion, and taking a plain film of the abdomen on that day is sufficient to make a diagnosis of constipation. Transit time studies are reproducible from month to month in patients with an irritable bowel syndrome. Control subjects who claim that their bowel habits are not modified by stress have shorter transit times, similar in both sexes, than those who say they are (P <0.001). This may explain why a large percentage of constipated patients have been found by most authors to have “normal” colorectal transit times. The choice of control subjects is thus a key element in studies of functional bowel motor disorders. Stool frequency and consistency, in health, correlate only to rectosigmoid transit time.
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References
Devroede G. Constipation. In: Sleisenger MH, Fordtran JS, eds. Gastrointestinal disease: pathophysiology, diagnosis, treatment. Philadelphia: WB Saunders, 1988:331–68.
Hinton JM, Lennard-Jones JE, Young AC, A new method for studying gut transit times using radiopaque markers. Gut 1969;10:842–7.
Martelli H, Devroede G, Arhan P, Duguay C, Dornic C, Faverdin C. Some parameters of large bowel motility in normal man. Gastroenterology 1978;75:612–8.
Martelli H, Devroede G, Arhan P, Duguay C. Mechanisms of idiopathic constipation: outlet obstruction. Gastroenterology 1978;75:623–31.
Arhan P, Devroede G, Jehannin B,et al. Segmental colonic transit time. Dis Colon Rectum 1981;24:625–9.
Hinton JM, Lennard-Jones JE. Constipation: definition and classification. Postgrad Med J 1968;44:720–3.
Devroede G. Dietary fiber, bowel habits, and colonic function. Am J Clin Nutr Suppl 1978;31:157–60.
Verduron A, Devroede G, Bouchoucha M,et al. Megarectum. Dig Dis Sci 1988;33:1164–74.
Chaussade S, Roche H, Khyari A, Couturier D, Guerre J. Mesure du temps de transit colique (TTC): Description et validation d'une nouvelle technique. Gastroenterol Clin Biol 1986;10:385–9.
Metcalf AM, Phillips SF, Zinsmeister AR, Mac Carty RL, Beart RW, Wolff BC. Simplified assessment of segmental colonic transit time. Gastroenterology 1987;92:40–7.
Abrahamsson H, Antov S, Bosaeus I. Gastrointestinal and colonic segmental transit time evaluated by a single abdominal x-ray in healthy subjects and constipated patients. Scand J Gastroenterol 1988;23(suppl 152):72–80.
Fotherby KJ, Hunter JO. Idiopathic slow transit constipation: whole gut transit times, measured by a new simplified method are not shortened by opioid antagonist. Aliment Pharmacol Ther 1987;1:331–8.
Devroede G, Girard G, Bouchoucha M,et al. Idiopathic constipation by colonic dysfunction: relationship with personality and anxiety. Dig Dis Sci 1989;34:1428–33.
Schang JC. Colonic motility in subgroups of patients with the irritable bowel syndrome. In: Proceedings of the first international symposium on small intestinal and colonic motility, Montréal, Canada, P. Poitras, ed. Centre de recherche clinique Hôpital Saint Luc and Jouveinal Laboratories/laboratoires, 1985.
Schang JC, Devroede G, Duguay C, Hemond M, Hebert M. Constipation par inertie colique et obstruction distale: étude électromyographique. Gastroenterol Clin Biol 1985;9:480–5.
Lanfranchi GA, Bazzocchi G, Brignola C, Campiere M, Labo G. Different patterns of intestinal transit time and anorectal motility in painful and painless constipation. Gut 1984;25:1352–7.
Wald A. Colonic transit and anorectal manometry in chronic idiopathic constipation. Arch Intern Med 1986;146:1713–6.
Ducrotte P, Rodomanska B, Weber J,et al. Colonic transit time of radiopaque markers and anorectal manometry in patients complaining of constipation. Dis Colon Rectum 1986;29:630–4.
Waldron D, Bowes KL, Kingmal YL, Cote KR. Colonic and anorectal motility in young women with severe idiopathic constipation. Gastroenterology 1988;95:1388–91.
Devroede G, Poisson J, Schang JC. Constipation: what is the appropriate therapeutic approach? In: Barkin JS, Rogers AL, eds. Difficult decisions in digestive diseases. Chicago: Year Book Medical Publishers, 1989:458–84.
Wald A, Hinds JP, Caruana BJ. Psychological and physiological characteristics of patients with severe idiopathic constipation. Gastroenterology 1989;97:932–7.
Chaussade S, Khyari A, Roche H,et al. Determination of total and segmental colonic transit time in constipated patients. Results in 91 patients with a new simplified method. Dig Dis Sci 1989;34:1068–172.
Drossman DA, Sandler RS, McKee DC, Lovitz J. Bowel patterns among subjects not seeking health-care. Use of a questionnaire to identify a population with bowel dysfunction. Gastroenterology 1982;83:529–34.
Tucker DM, Sandstead HH, Logan GM,et al. Dietary fiber and personality factors as determinants of stool output. Gastroenterology 1981;81:878–83.
Kruis W, Thieme CH, Weinzierl M, Schussler P, Holl J, Paulus W. A diagnostic score for the irritable bowel syndrome. Its value in the exclusion of organic disease. Gastroenterology 1984;87:1–7.
Winner BJ. Statistical principles in experimental design. 2nd ed. New York: McGraw Hill, 1971:298–378.
Athanasios Papoolis. Signal analysis. New York: McGraw Hill, 1977.
Cummings JH, Wiggins H. Transit through the gut measured by analysis of a single stool. Gut 1976;17:219–23.
Metcalf A. Transit time. In: Smith LE, ed. A practical guide to ano-rectal testing. New York: IGAKU-SHOIN, 1990:17–22.
Hinds JP, Stoney B, Walds A. Does gender or the menstrual cycle affect colonic transit? Am J Gastroenterol 1989;84:123–6.
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Bouchoucha, M., Devroede, G., Arhan, P. et al. What is the meaning of colorectal transit time measurement?. Dis Colon Rectum 35, 773–782 (1992). https://doi.org/10.1007/BF02050328
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DOI: https://doi.org/10.1007/BF02050328