BACKGROUND: Measuring colonic transit time (CTT) by the radio-opaque marker method is simple, widely available and important for the diagnosis of slow transit constipation. Moreover, the effects of gender and menstrual cycle on CTT remain controversial. Thus, in this study, we examined the effects of gender and menstrual cycle on CTT in healthy subjects. METHODS: We measured CTT in 42 healthy subjects (21M, 21F) by using a radio-opaque marker, Kolomark (TM). Two simple abdominal radiographs were taken on the 4th and 7th days. Average daily intake of dietary fiber and menstrual history were surveyed. RESULTS: The mean CTT of the 42 healthy subjects was 26.5 +/- 19.4 hours. The mean CTT was not significantly different between the male and female subjects (22.3 +/- 16.1 h vs. 30.1 +/- 21.4 h, p> 0.05). However, the mean CTT of 11 female subjects in the luteal phase was significantly longer than that of 10 female subjects in the follicular phase (40.9 +/- 19.0 h vs. 20.6 +/- 19.2 h, p< 0.05). Serum progesterone level, age, BMI, and the average daily intake of dietary fiber did not correlate with CTT. CONCLUSION: The effects of the menstrual cycle should be considered in interpreting CTT in young women.
Adult ; Colon/*physiopathology/radiography ; Comparative Study ; Constipation/physiopathology/radiography ; Contrast Media ; Female ; Gastrointestinal Transit/*physiology ; Human ; Male ; Menstrual Cycle/*physiology ; Middle Aged ; Radiography, Abdominal ; Sex Factors ; Support, Non-U.S. Gov't

OBJECTIVETo discuss the clinical value and application range of defecography, CT and MRI in diagnosis of puborectalis syndrome (PRS).

METHODSThe clinical data of 83 PRS patients, including defecography, CT and MRI scanning in pelvic floor resting and defecation at maximum exertion, measurement of anorectal angle (ARA), length and depth of ARA impression and the thickness of the puborectalis muscle, were collected, and compared with those of 56 normal persons.

RESULTSFor normal persons, ARA at maximum exertion was more significantly increased than that at resting. In 62 cases with PRS, ARA at maximum exertion was more obviously reduced than that at resting and associated with puborectalis muscle (PRM) impression. In the other 21 cases, ARA showed no changes at either maximum exertion or resting, a little or no excretion of barium appeared and "shelving syndrome" was showed. The cross-sectional images of CT and MRI showed that the puborectalis of PRS patients were thicker than that of normal persons (P<0.01). PRS patients also showed clear pelvic floor muscle, fasciae and peripheral crevice.

CONCLUSIONSDefecography, manifested the abnormal function of the puborectalis muscles, is a reliable method for diagnosis of PRS. In the meantime, CT and MRI are able to clearly display the position, growth status and size of the puborectalis muscles as well as its relation with adjacent structures, which provide further understandings on anatomical changes, abnormal adjacent structure and other functional diseases of pelvic floor in PRS patients. Therefore, an appropriate combination of the 3 methods play an important role in the early diagnosis of PRS and guidance for surgical treatment.

Adolescent ; Adult ; Aged ; Constipation ; diagnostic imaging ; pathology ; physiopathology ; Fecal Incontinence ; Female ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Magnetic Resonance Imaging ; Male ; Microscopy, Electron ; Middle Aged ; Muscular Diseases ; diagnostic imaging ; physiopathology ; Perineum ; Radiography ; Rectal Diseases ; diagnostic imaging ; pathology ; physiopathology ; Syndrome ; Young Adult