Skip to main content

Advertisement

SpringerLink
Log in

Defaecography and colonic transit time for the evaluation of female patients with obstructed defaecation

  • Abdominal Radiology
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

Colonic transit time and defaecography are well known, commonly used studies for evaluating patients with chronic constipation. The aim of this study was to compare colonic transit time with radiopaque markers and defaecography in female patients with obstructed defaecation.

Materials and methods

In a prospective observational study, between January 2010 and December 2012, a total of 30 female patients, mean age 60 years, with symptoms of obstructed defaecation were subjected to colonic transit time and defaecography, and divided into two groups: normal or abnormal colon transit time. The results were statistically compared using the Chi-square test.

Results

The comparison of data between colonic transit time and defaecography showed the following groups: group 1 (6/30 = 20 %) with normal colonic transit time but abnormal defaecography, and group 2 (24/30 = 80 %) with abnormal colonic transit time; the latter was further divided into two subgroups: group 2a (4/24 = 17 %), patients with inertia coli; group 2b (20/24 = 83 %), patients with impaired defaecation demonstrated at defaecography. There was a significant statistical difference between the radiological findings in these groups.

Conclusions

This study confirmed the value of both defaecography and colonic transit time in assessing clinically obstructed women. Obstructed defaecation might not always be associated with abnormal colonic transit time. Likewise, not all constipated patients had signs of obstructed defaecation. The differential diagnosis between colonic slow transit constipation and constipation due to pelvic floor disorders is essential for an adequate strategy of care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. D’Hoore A, Penninckx F (2003) Obstructed defecation. Colorectal Dis 5:280–287

    Article  PubMed  Google Scholar 

  2. Pare P, Ferrazzi S, Thompson WG et al (2001) An epidemiological survey of constipation in Canada: definitions, rates, demographics and predictors of health care seeking. Am J Gastroenterol 96:3130–3137

    Article  CAS  PubMed  Google Scholar 

  3. Higgins PD, Johanson JF (2004) Epidemiology of constipation in North America: a systemic review. Am J Gastroenterol 99:750–759

    Article  PubMed  Google Scholar 

  4. Remes-Troche JM, Rao SSC (2006) Diagnostic testing in patients with chronic constipation. Curr Gastroenterol Rep 8:416–424

    Article  PubMed  Google Scholar 

  5. Ternent CA, Bastawrous AL, Morin NA et al (2007) Practice parameters for the evaluation and management of constipation. Dis Colon Rectum 50:2013–2022

    Article  PubMed  Google Scholar 

  6. Videlock EJ, Lembo A, Cremonini F (2013) Diagnostic testing for dyssynergic defecation in chronic constipation: meta-analysis. Neurogastroenterol Motil 25:509–520

    Article  CAS  PubMed  Google Scholar 

  7. Perniola G, Shek C, Chong CCW et al (2008) Defecation proctography and translabial ultrasound in the investigation of defecatory disorders. Ultrasound Obstet Gynecol 31:567–571

    Article  CAS  PubMed  Google Scholar 

  8. Pescatori M, Boffi F, Russo A, Zbar AP (2006) Complications and recurrence after excision of rectal internal mucosal prolapse for obstructed defaecation. Int J Colorectal Dis 21:160–165

    Article  CAS  PubMed  Google Scholar 

  9. Piloni V, Pieri L, Pomerri F et al (1996) The 3rd National Workshop on defecography: the functional radiology of (neo) rectal ampullae (ileal reservoir, colo-anal anastomosis, continent perineal colostomy). Radiol Med 91:66–72 (Article in Italian)

    CAS  PubMed  Google Scholar 

  10. Piloni V, Pomerri F, Platania E et al (1994) The National Workshop on defecography: anorectal deformities with a functional origin (prolapse, intussusception, rectocele). Radiol Med 87:789–795 (Article in Italian)

    CAS  PubMed  Google Scholar 

  11. Panicucci S, Martellucci J, Menconi C et al (2013) Correlation between outcome and instrumental findings after stapled transanal rectal resection for obstructed defecation syndrome. Surg Innov. doi:10.1177/1553350613505718

  12. Pomerri F, Frigo A, Grigoletto F et al (2007) Error count of radiopaque markers in colonic segmental transit time study. AJR Am J Roentgenol 189:w56–w59

    Article  PubMed  Google Scholar 

  13. Bouchouca M, Devroede G, Arhan P et al (1996) What is the meaning of colorectal transit time measurement? Dis Colon Rectum 35:773–882

    Article  Google Scholar 

  14. Karasick S, Ehrlich SM (1996) Is constipation a disorder of defecation or impaired motility? Distinction based on defecography and colonic transit studies. AJR Am J Roentgenol 166:63–66

    Article  CAS  PubMed  Google Scholar 

  15. Salvetti M, Zilocchi M, Fornari S et al (2007) Colonic transit time and defecography. Urodinamica 17:23–27

    Google Scholar 

  16. Morandi C, Martellucci J, Talento P et al (2010) Role of enterocele in the obstructed defecation syndrome (ODS): a new radiological point of view. Colorectal Dis 12:810–816

    Article  CAS  PubMed  Google Scholar 

  17. Kerremans R (1968) Radio-cinematographic examination of the rectum and the anal canal in cases of rectal constipation. A radio-cinematographic and physical explanation of dyschezia. Acta Gastro-Enterologica Belgica 31:561

    CAS  PubMed  Google Scholar 

  18. Mahieu P, Pringot J, Bodart P (1984) Defecography 1. Description of a new procedure and results in normal patients. Gastrointest Radiol 9:247–251

    Article  CAS  PubMed  Google Scholar 

  19. Jorge JM, Habr-Gama A, Wexner SD et al (2001) Clinical application and techniques of cinedefecography. Am J Surg 182:93–101

    Article  CAS  PubMed  Google Scholar 

  20. Murad-Regadas S, Peterson TV, Pinto RA et al (2009) Defecographic pelvic floor abnormalities in constipated patients: does mode of delivery matter? Tech Coloproctol 13:279–283

    Article  PubMed  Google Scholar 

  21. Piloni V, Genovesi N, Grassi R et al (1993) National working team report on defecography. Radiol Med 85:784–793 (Article in Italian)

    CAS  PubMed  Google Scholar 

  22. Cappabianca S, Reginelli A, Iacobellis F et al (2011) Dynamic MRI defecography vs entero-colpo-cysto-defecography in the evaluation of middle pelvic floor hernias in female pelvic floor disorders. Int J Colorectal 26:1191–1196

    Article  Google Scholar 

  23. Wong SW, Lubowski DZ (2007) Slow transit constipation: evaluation and treatment. ANZ J Surg 77:320–328

    Article  PubMed  Google Scholar 

  24. Evans RC, Kamm MA, Hinton JM et al (1992) The normal range and a simple diagram for recording whole gut transit time. Int J Colorectal Dis 7:15–17

    Article  CAS  PubMed  Google Scholar 

  25. Halligan S, Bartram C, Hall C et al (1996) Enterocele revealed by simultaneous evacuation proctography and peritoneography: does “defecation block” exist? AJR Am J Roentgenol 167:461–466

    Article  CAS  PubMed  Google Scholar 

  26. Grassi R, Pomerri F, Habib F et al (1995) Defecography study of outpouchings of the external wall of the rectum: posterior rectocele and ischio-rectal hernia. Radiol Med 90:44–48 (Article in Italian)

    CAS  PubMed  Google Scholar 

  27. Cavallo G, Salzano A, Grassi R et al (1991) Rectocele in males: clinical, defecographic, and CT study of singular cases. Dis Colon Rectum 34:964–966

    Article  CAS  PubMed  Google Scholar 

  28. Cavallo G, Salzano A, Grassi R et al (1993) Functional intraperineal pouch of rectal wall (posterior rectocele). Dis Colon Rectum 36:179–181

    Article  CAS  PubMed  Google Scholar 

  29. Karasick S, Spettell CM (1997) The role of parity and hysterectomy on the development of the pelvic floor abnormalities revealed by defecography. AJR Am J Roentgenol 169:1555–1558

    Article  CAS  PubMed  Google Scholar 

  30. Salzano A, Nocera V, Rossi E et al (2000) Radiologic investigation of external rectal prolapse. Assessment in 48 patients with defecography, seven of them also with dynamic CT of the pelvis. Radiol Med 100:348–353 (Article in Italian)

    CAS  PubMed  Google Scholar 

  31. Salzano A, Grassi R, Habib I et al (1998) The defecographic and clinical aspects of the solitary rectal ulcer syndrome. Radiol Med 95:588–592 (Article in Italian)

    CAS  PubMed  Google Scholar 

  32. Vitton V, Vignally P, Barthet M et al (2011) Dynamic anal endosonography and MRI defecography in diagnosis of pelvic floor disorders: comparison with conventional defecography. Dis Colon Rectum 54:1398–1404

    Article  PubMed  Google Scholar 

  33. Karaus M, Neuhaus P et al (2000) Diagnosis of enterocele by dynamic anorectal endosonography. Dis Colon Rectum 43:1683–1688

    Article  CAS  PubMed  Google Scholar 

  34. Murad-Regadas SM, Regadas FS, Rodrigues LV et al (2008) A novel three-dimensional dynamic anorectal ultrasonography technique (echo defecography) to assess obstructed defecation, a comparison with defecography. Surg Endosc 22:974–979

    Article  PubMed  Google Scholar 

  35. Grassi R, Rotondo A, Catalano O et al (1995) Endoanal ultrasonography, defecography, and enema of the colon in the radiologic study of incontinence. Radiol Med 89:792–797 (Article in Italian)

    CAS  PubMed  Google Scholar 

Download references

Conflict of interest

Maria Cosentino, Claudio Beati, Simona Fornari, Emanuela Capalbo, Michela Peli, Maria Lovisatti, Maurizio Cariati, and Gianpaolo Cornalba declare no conflict of interest.

Author information

Authors and Affiliations

  1. Dipartimento di Scienze Diagnostiche, Unità Operativa Complessa di Radiologia, Ospedale San Carlo Borromeo, Via Pio II, 3, 20153, Milan, Italy

    Maria Cosentino, Simona Fornari, Emanuela Capalbo, Michela Peli, Maria Lovisatti & Maurizio Cariati

  2. Dipartimento di Scienze Chirurgiche, Unità di Colo-proctologia, Ospedale San Carlo Borromeo, Via Pio II, 3, 20153, Milan, Italy

    Claudio Beati

  3. Scuola di specializzazione in Radiodiagnostica e Radiologia Interventistica, Università degli Studi di Milano, Via A. Di Rudini 8, 20142, Milan, Italy

    Maria Cosentino, Emanuela Capalbo, Michela Peli, Maria Lovisatti & Gianpaolo Cornalba

Authors
  1. Maria Cosentino
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Claudio Beati
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Simona Fornari
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Emanuela Capalbo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michela Peli
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Maria Lovisatti
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Maurizio Cariati
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Gianpaolo Cornalba
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Maria Cosentino.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cosentino, M., Beati, C., Fornari, S. et al. Defaecography and colonic transit time for the evaluation of female patients with obstructed defaecation. Radiol med 119, 813–819 (2014). https://doi.org/10.1007/s11547-014-0405-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11547-014-0405-0

Keywords

Search

Navigation