1.How to Interpret a Functional or Motility Test: Colon Transit Study.
Journal of Neurogastroenterology and Motility 2012;18(1):94-99
Measurement of colon transit time is the most basic and primary tool in evaluating disorders of colonic motility. In particular, it is helpful in pathologic diagnosis and for planning management in patients with constipation. Several techniques for measuring colon transit time currently exist. The standard measurement of colon transit time has been performed using radioopaque marker test. The radioopaque marker test is the most widely used method; it is simple to perform as well as being cost effective. But, this technique produces radiation exposure. Radionuclide scintigraphy and wireless motility capsules are other techniques used to measure colon transit time. In radionuclide scintigraphy, the transit of radioisotope is viewed by gamma camera; this approach has an advantage in that it uses minimal radiation and it allows a physiological assessment of gastrointestinal transit. Wireless motility capsules have been validated most recently, but this technique is not useful in Korea. This review presents the techniques used to measure colon transit time and the interpretations provided in different colon transit studies.
Capsules
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Colon
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Constipation
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Gastrointestinal Transit
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Humans
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Imidazoles
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Korea
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Nitro Compounds
2.Relevance of Colonic Gas Analysis and Transit Study in Patients With Chronic Constipation.
Seon Young PARK ; Hyun Bum PARK ; Ji Myung LEE ; Ho Jun LEE ; Chang Hwan PARK ; Hyun Soo KIM ; Sung Kyu CHOI ; Jong Sun REW
Journal of Neurogastroenterology and Motility 2015;21(3):433-439
BACKGROUND/AIMS: Colon transit time (CTT) is a useful diagnostic tool in chronic constipation, but requires good patient compliance. We analyzed the correlation between the gas volume score (GVS) and CTT in patients with chronic constipation. METHODS: The study included 145 consecutive patients (65 men) with chronic constipation. The primary outcome was the correlation between the colon GVS and CTT. Secondary outcomes were the differences in colon GVS according to CTT and subtypes of chronic constipation. RESULTS: There were 81 patients with "CTT < 45 hours" and 64 patients with "CTT > or = 45 hours." In addition, 88 patients were classified as having functional constipation and 57 were classified as having constipation predominant irritable bowel syndrome (IBS-C). There was no significant correlation between CTT and colon GVS. However, the right colon GVS showed a positive correlation with right CTT (r = 0.255, P = 0.007). The median total colon GVS was significantly higher in patients with "CTT > or = 45 hours" than in those with "CTT < 45 hours" (5.65% vs 4.15%, P = 0.010). There were no significant differences in colon GVS between the functional constipation and IBS-C. CONCLUSIONS: We were unable to detect a correlation between GVS and CTT in patients with chronic constipation. However, total colon GVS may be a method of predicting slow transit in patients with chronic constipation.
Colon*
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Constipation*
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Gastrointestinal Transit
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Humans
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Irritable Bowel Syndrome
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Patient Compliance
5.Etiology and clinical classification of constipation.
X L ZENG ; X D YANG ; T YANG ; X L HUANG ; S LIU
Chinese Journal of Gastrointestinal Surgery 2022;25(12):1120-1125
The causes of constipation are extremely complex and are still not fully clear. In addition to secondary factors such as organic diseases and drugs, constipation may also be related to genetics, diet, intestinal flora, age, gender and so on. At present, according to the etiology, chronic constipation is divided into primary constipation and secondary constipation. However, there are significant differences among current clinical guidelines in the clinical classification of primary constipation. Some guidelines classify primary constipation as slow-transit constipation (STC), outlet obstruction constipation (OOC), and mixed constipation; however, some guidelines classify primary constipation as STC, defecation disorder (DD), mixed constipation, and normal-transit constipation (NTC); what's more, some even propose types which are different from the above sub-types. There are also differences in the understanding of the relationship between functional constipation (FC) and primary constipation and the classification of irritable bowel syndrome predominant constipation (IBS-C) among various clinical guidelines. By reviewing domestic and international guidelines and relevant literature on constipation, the following conclusions are drawn: primary constipation can be divided into IBS-C and FC, and FC can be further divided into STC, OOC, and mixed constipation; primary constipation should not be confused with FC, nor should IBS-C be classified as FC.
Humans
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Irritable Bowel Syndrome/complications*
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Constipation/etiology*
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Gastrointestinal Transit
6.Chinese surgical diagnosis and treatment consensus on slow transit constipation (2023 edition).
Chinese Journal of Gastrointestinal Surgery 2023;26(12):1112-1121
In recent years, advancements have been made in both basic and surgical research of slow-transit constipation (STC). However, compelling references for surgeons in the clinical practice of STC have been lacking, particularly on preoperative evaluation and the choice of surgical procedures. In order to further standardize the diagnosis, assessment and surgical management of STC, Chinese Medical Doctor Association Anorectal Doctor Branch and its Functional Diseases Committee selected relevant experts in the field of STC surgery in China to form the Editorial and Review Committee of the Expert Consensus on Diagnosis, Evaluation and Surgical Management of STC in China. By meticulously reviewing relevant literature from both domestic and international sources and integrating the clinical expertise of the panel of experts, the committee has formulated 20 recommendations. These recommendations aim to establish standardized processes for surgical diagnosis and treatment of STC, ultimately elevating the overall diagnostic and therapeutic standards for STC across China.
Humans
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Consensus
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Gastrointestinal Transit
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Constipation/surgery*
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Colectomy
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China
7.Scintigraphic Evaluation of Gastrointestinal Motility Disorders.
Korean Journal of Nuclear Medicine 2001;35(1):1-11
Current scintigraphic tests of gastrointestinal motor function provides relevant pathophysiologic information, but their clinical utility is controversial. Many scintigraphic methods are developed to investigate gastrointestinal motility from oral cavity to colon. These are esophageal transit scintigraphy, oropharyngeal transit study, gastric emptying test, small bowel transit time measurement, colon transit study and gastroesopahgeal reflux scintigraphy. Scintigraphy of gastrointestinal tract is the most physiologic and noninvasive method to evaluate gastrointestinal motility disorders. Stomach emptying test is regarded as a gold standard in motility study. Gastrointestinal transit scintigraphy also has a certain role in assessment of drug effect to GI motility and changes after therapy of motility disorders. Scintigraphy provides noninvasive and quantitative assessment of physiological transit throughout the gastrointestinal tract, and it is extremely useful for diagnosing gastrointestinal motor dysfunction. This article reviews the current procedures, indications, significance and guidelines for gastrointestinal motility measurements by scintigraphy.
Colon
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Gastric Emptying
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Gastrointestinal Motility*
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Gastrointestinal Tract
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Gastrointestinal Transit
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Mouth
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Radionuclide Imaging
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Stomach
8.Assessment on Gastrointestinal Transit Movement of Capsule Endoscopy in Beagle Dogs.
Hwa Seok CHANG ; Hee Taek YANG ; Sang Young KIM ; Dong Cheol WOO ; Woo Dae PARK ; Joon Hwan YONG ; Bo Young CHOE ; Hwi Yool KIM ; Chi Bong CHOI
Korean Journal of Medical Physics 2008;19(2):125-130
The object of this study is to measure the transit time and passage rate of capsule endoscopy (CE) in the gastrointestinal tract in medium sized beagle dogs (7~13 kg). Animals were divided into four groups: only capsule (group 1, n=10), capsule+water (group 2, n=10), mettoclopramide+capsule (group 3, n=10), metoclopramide +capsule+water (group 4, n=10). The capsule transit times through the stomach and small bowel were evaluated by radiography findings. Gastric transit time (GTT), small intestinal transit time (SITT) and complete passage rate were measured in four groups. GTT's for each group were as follows; 45+/-20 min (group 1), 117+/-35 min (group 2), 150+/-40 min (group 3), and 154+/-65 min (group 4), while SITT's were 75+/-20 min (group 1), 195+/-55 min (group 2), 70+/-15 min (group 3), and 76+/-15 min (group 4). The complete passage rates were 20% (group 1), 40% (group 2), 20% (group 3), 50% (group 4). In all groups, if CE could pass through the pylorus, it passed all small intestinal tracts within 8 hours (battery life). Administration of water helped CE to pass pylori, except in case of metoclopramide administration. These results indicate that CE could be an useful tool for examining gastrointestinal diseases in the veterinary medicine.
Animals
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Capsule Endoscopy
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Dogs
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Gastrointestinal Diseases
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Gastrointestinal Tract
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Gastrointestinal Transit
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Metoclopramide
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Pylorus
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Stomach
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Veterinary Medicine
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Water
9.Regional Gastrointestinal Transit Times in Patients With Carcinoid Diarrhea: Assessment With the Novel 3D-Transit System.
Tine GREGERSEN ; Anne Mette HAASE ; Vincent SCHLAGETER ; Henning GRONBAEK ; Klaus KROGH
Journal of Neurogastroenterology and Motility 2015;21(3):423-432
BACKGROUND/AIMS: The paucity of knowledge regarding gastrointestinal motility in patients with neuroendocrine tumors and carcinoid diarrhea restricts targeted treatment. 3D-Transit is a novel, minimally invasive, ambulatory method for description of gastrointestinal motility. The system has not yet been evaluated in any group of patients. We aimed to test the performance of 3D-Transit in patients with carcinoid diarrhea and to compare the patients' regional gastrointestinal transit times (GITT) and colonic motility patterns with those of healthy subjects. METHODS: Fifteen healthy volunteers and seven patients with neuroendocrine tumor and at least 3 bowel movements per day were investigated with 3D-Transit and standard radiopaque markers. RESULTS: Total GITT assessed with 3D-Transit and radiopaque markers were well correlated (Spearman's rho = 0.64, P = 0.002). Median total GITT was 12.5 (range: 8.5-47.2) hours in patients versus 25.1 (range: 13.1-142.3) hours in healthy (P = 0.007). There was no difference in gastric emptying (P = 0.778). Median small intestinal transit time was 3.8 (range: 1.4-5.5) hours in patients versus 4.4 (range: 1.8-7.2) hours in healthy subjects (P = 0.044). Median colorectal transit time was 5.2 (range: 2.9-40.1) hours in patients versus 18.1 (range: 5.0-134.0) hours in healthy subjects (P = 0.012). Median frequency of pansegmental colonic movements was 0.45 (range: 0.03-1.02) per hour in patients and 0.07 (range: 0-0.61) per hour in healthy subjects (P = 0.045). CONCLUSIONS: Three-dimensional Transit allows assessment of regional GITT in patients with diarrhea. Patients with carcinoid diarrhea have faster than normal gastrointestinal transit due to faster small intestinal and colorectal transit times. The latter is caused by an increased frequency of pansegmental colonic movements.
Capsules
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Carcinoid Tumor*
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Colon
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Diarrhea*
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Gastric Emptying
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Gastrointestinal Motility
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Gastrointestinal Transit*
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Healthy Volunteers
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Humans
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Neuroendocrine Tumors
10.Defecation Frequency and Stool Form in a Coastal Eastern Indian Population.
Manas Kumar PANIGRAHI ; Sanjib Kumar KAR ; Shivaram Prasad SINGH ; Uday C GHOSHAL
Journal of Neurogastroenterology and Motility 2013;19(3):374-380
BACKGROUND/AIMS: Data on normal stool form and frequency, which are important for defining constipation, are scanty; hence, we studied these in an eastern Indian population. METHODS: One thousand and two hundred apparently healthy asymptomatic subjects were evaluated for predominant stool form (Bristol chart with descriptor) and frequency. Data on demographic and life-style (diet and physical activity) were collected. RESULTS: Of 1,200 subjects (age 42 +/- 14.5 years, 711, 59% male), most passed predominantly Bristol type IV stool (699 [58.2%]; other forms were: type I (23 [1.9%]), type II (38 [3.2%]), type III (99 [8.2%]), type V (73 [6%]), type VI (177 [14.7%]), type VII (7 [0.6%]) and an irregular combination (84 [7%]). Weekly stool frequency was 12.1 +/- 4.7 (median 14, range 2-42). Less than 3 stools/week was noted in 32/1,200 (2.6%). Female subjects (n = 489) passed stools less frequently than males (n = 711) (11.1 +/- 5.6/week vs. 12.8 +/- 3.8/week, P < 0.001) and tended to pass harder forms (type I: 17, type II: 20, type III: 39 vs. 6, 18 and 60, respectively, P = 0.061). Vegetarians (n = 252) and physically active (n = 379) subjects tended to pass stool more frequently than occasional (n = 553) and regular non-vegetarian (n = 395) (11.8 +/- 4.5 and 12.8 +/- 4.7 vs. 11.3 +/- 4.7; P < 0.05) and sedentary (n = 464) and intermediately active (n = 357) subjects (13.4 +/- 4.0 and 12.3 +/- 4.5 vs. 10.9 +/- 5.1, P = 0.080) in different age groups, respectively. Older age was associated with less frequent stool, particularly among female population. Female gender and age > 35 years were significant on multivariate analysis. CONCLUSIONS: Median stool frequency in the studied population was 14/week (range 2-42) and predominant form was Bristol type IV. Older age was associated with lesser stool frequency, particularly among female subjects.
Constipation
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Defecation
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Female
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Gastrointestinal Diseases
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Gastrointestinal Transit
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Humans
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Irritable Bowel Syndrome
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Male