OBJECTIVETo investigate the characteristics of gastrointestinal transit in chronic constipation patients depending on a small amount barium(SAB) gastrointestinal transit test.

METHODSImaging data of 1890 cases with chronic constipation diagnosed with Rome III( criteria undergoing the SAB gastrointestinal transit test at Department of Colorectal Surgery, The First Affiliated Hospital of Zhengzhou University from January 2009 to March 2015 were retrospectively analyzed. All the patients took 20 g medical barium sulfate diluted in porridge and erect position abdominal X-ray photographs were then taken at 4, 8, 12, 24 hours after meal and once in every 24 hour sequentially. Transit characteristics of whole gut and various segments, including stomach, small intestine, right hemicolon, left hemicolon and rectum were assessed according to the predetermined criteria.

RESULTSAll the 1890 patients showed good compliance with the complete test. Among these patients, 794 cases(42%) were diagnosed as normal transit and 1096 cases(58%) as gastrointestinal slow transit. Classified by the site of slow transit, 151 cases(8%) were abnormal gastric transit, 175(9%) cases were abnormal small intestinal transit, 986(52%) cases were slow right hemicolon transit, 1039 cases(55%) were slow left hemicolon transit, 139 cases(7%) were outlet obstruction. Among the 1096 patients with slow gut transit, 907 cases(83%) were multiple segments slow transit and 189 cases(17%) were single segment slow transit. Among 907 patients with multiple segmental slow transit, 668 cases(74%) were total colon slow transit, 61 cases(7%) were colonic slow transit combined with outlet obstruction, 138 cases(15%) were small intestine slow transit coincided with colon slow transit, 40 cases(4%) were total segments slow transit in the whole gut. Of 189 cases of single segment slow transit, 17 cases(9%) were unique gastric delayed empting, 37 cases(20%) were unitary small intestine transit dysfunction, 19 cases(10%) were right hemicolon transit defect, 78 cases(41%) were left hemicolon transit deterioration, 38 cases(20%) were outlet obstruction.

CONCLUSIONSThe characteristics of gastrointestinal transit test in patients with chronic constipation varied from each other. Majority presents multi-segment slow transit combined with colon slow transit. SAB gastrointestinal transit test is helpful for surveying the transit characteristics of each segment of gut and worth clinical generalization and application.