Pediatric Surgery International

, Volume 25, Issue 7, pp 559–572 | Cite as

Colonic transit studies: normal values for adults and children with comparison of radiological and scintigraphic methods

  • Bridget R. Southwell
  • Melanie C. C. Clarke
  • Jonathan Sutcliffe
  • John M. Hutson
Review Article

Abstract

The sitz or plastic marker study for colonic transit has been around for many years. It is applicable where an X-ray machine exists, is widely used and is accepted as the gold standard for diagnosing constipation. Recently, radiopharmaceutical methods have been developed. The theme of this review is their possible roles in the assessment of paediatric bowel motility disorders in patients presenting to paediatric surgeons. This review presents data on total and segmental transit in normal adults and children and comparing the two techniques in adults. Reliability and reproducibility are presented. Normative data for colonic transit in adults and children are discussed and parameters for assessing abnormal transit are reviewed. Normal colonic transit takes 20–56 h. Plastic marker studies are more readily accessible, but the assessment may be misleading with current methods. Plastic markers show faster transit than scintigraphy. It is difficult to compare the two techniques because methods of reporting are different. Using scintigraphy, repeatability is good. Separation of normal from slow transit in the ascending colon is apparent at 24 and 48 h, but the determination of transit through the distal colon/rectum in adults may require studies of more than 7 days. In conclusion, plastic marker studies and scintigraphy show similar transit rates in young adults and children. However, scintigraphy has advantages of allowing transit through the stomach and small intestine to be measured and has proved useful in the diagnostic workup of children with intractable constipation.

Keywords

Slow transit constipation Nuclear transit studies Sitz markers Scintigraphy Paediatric constipation 

References

  1. 1.
    Chitkara DK, Talley NJ, Weaver AL, Katusic SK, De Schepper H, Rucker MJ, Locke GRIII (2007) Incidence of presentation of common functional gastrointestinal disorders in children from birth to 5 years: a cohort study. Clin Gastroenterol Hepatol 5(2):186–191. doi:10.1016/j.cgh.2006.06.012 PubMedGoogle Scholar
  2. 2.
    van Ginkel R, Reitsma JB, Buller HA, van Wijk MP, Taminiau JA, Benninga MA (2003) Childhood constipation: longitudinal follow-up beyond puberty. Gastroenterology 125(2):357–363. doi:10.1016/S0016-5085(03)00888-6 PubMedGoogle Scholar
  3. 3.
    Chitkara DK, Talley NJ, Locke GRIII, Weaver AL, Katusic SK, De Schepper H, Rucker MJ (2007) Medical presentation of constipation from childhood to early adulthood: a population-based cohort study. Clin Gastroenterol Hepatol 5(9):1059–1064. doi:10.1016/j.cgh.2007.04.028 PubMedGoogle Scholar
  4. 4.
    NASPGHAN CGC (2006) Evaluation and treatment of constipation in infants and children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr 43(3):e1–e13. doi:10.1097/01.mpg.0000233159.97667.c3 Google Scholar
  5. 5.
    NASPGHAN CGC (2006) Evaluation and treatment of constipation in children: summary of updated recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr 43(3):405–407. doi:10.1097/01.mpg.0000232574.41149.0a Google Scholar
  6. 6.
    Brandt LJ, Prather CM, Quigley EM, Schiller LR, Schoenfeld P, Talley NJ (2005) Systematic review on the management of chronic constipation in North America. Am J Gastroenterol 100(Suppl 1):S5–S21. doi:10.1111/j.1572-0241.2005.50613_2.x PubMedGoogle Scholar
  7. 7.
    Maurer AH, Krevsky B (1995) Whole-gut transit scintigraphy in the evaluation of small-bowel and colon transit disorders. Semin Nucl Med 25(4):326–338. doi:10.1016/S0001-2998(95)80006-9 PubMedGoogle Scholar
  8. 8.
    Maurer AH, Parkman HP (2006) Update on gastrointestinal scintigraphy. Semin Nucl Med 36(2):110–118. doi:10.1053/j.semnuclmed.2005.12.003 PubMedGoogle Scholar
  9. 9.
    Lin HC, Prather C, Fisher RS, Meyer JH, Summers RW, Pimentel M, McCallum RW, Akkermans LM, Loening-Baucke V (2005) Measurement of gastrointestinal transit. Digest Dis Sci 50(6):989–1004. doi:10.1007/s10620-005-2694-6 PubMedGoogle Scholar
  10. 10.
    Sadik R, Stotzer PO, Simren M, Abrahamsson H (2008) Gastrointestinal transit abnormalities are frequently detected in patients with unexplained GI symptoms at a tertiary centre. Neurogastroenterol Motil 20(3):197–205. doi:10.1111/j.1365-2982.2007.01025.x PubMedGoogle Scholar
  11. 11.
    Proano M, Camilleri M, Phillips SF, Brown ML, Thomforde GM (1990) Transit of solids through the human colon: regional quantification in the unprepared bowel. Am J Physiol 258(6 Pt 1):G856–G862PubMedGoogle Scholar
  12. 12.
    Eising EG, von der Ohe MR (1998) Differentiation of prolonged colonic transit using scintigraphy with indium-111-labeled polystyrene pellets. J Nucl Med 39(6):1062–1066PubMedGoogle Scholar
  13. 13.
    Hinton JM, Lennard-Jones JE, Young AC (1969) A new method for studying gut transit times using radioopaque markers. Gut 10(10):842–847. doi:10.1136/gut.10.10.842 PubMedGoogle Scholar
  14. 14.
    Bouchoucha M, Devroede G, Arhan P, Strom B, Weber J, Cugnenc PH, Denis P, Barbier JP (1992) What is the meaning of colorectal transit time measurement? Dis Colon Rectum 35(8):773–782. doi:10.1007/BF02050328 PubMedGoogle Scholar
  15. 15.
    Karasick S, Ehrlich SM (1996) Is constipation a disorder of defecation or impaired motility?: distinction based on defecography and colonic transit studies. Am J Roentgenol 166(1):63–66Google Scholar
  16. 16.
    Nino-Murcia M, Friedland GW (1992) Functional abnormalities of the gastrointestinal tract in patients with spinal cord injuries: evaluation with imaging procedures. Am J Roentgenol 158(2):279–281Google Scholar
  17. 17.
    Pomerri F, Frigo AC, Grigoletto F, Dodi G, Muzzio PC (2007) Error count of radiopaque markers in colonic segmental transit time study. Am J Roentgenol 189(2):W56–W59. doi:10.2214/AJR.07.2278 Google Scholar
  18. 18.
    Evans RC, Kamm MA, Hinton JM, Lennard-Jones JE (1992) The normal range and a simple diagram for recording whole gut transit time. Int J Colorectal Dis 7(1):15–17. doi:10.1007/BF01647654 PubMedGoogle Scholar
  19. 19.
    Arhan P, Devroede G, Jehannin B, Lanza M, Faverdin C, Dornic C, Persoz B, Tetreault L, Perey B, Pellerin D (1981) Segmental colonic transit time. Dis Colon Rectum 24(8):625–629. doi:10.1007/BF02605761 PubMedGoogle Scholar
  20. 20.
    Martelli H, Devroede G, Arhan P, Duguay C (1978) Mechanisms of idiopathic constipation: outlet obstruction. Gastroenterology 75(4):623–631PubMedGoogle Scholar
  21. 21.
    Martelli H, Devroede G, Arhan P, Duguay C, Dornic C, Faverdin C (1978) Some parameters of large bowel motility in normal man. Gastroenterology 75(4):612–618PubMedGoogle Scholar
  22. 22.
    Metcalf AM, Phillips SF, Zinsmeister AR, MacCarty RL, Beart RW, Wolff BG (1987) Simplified assessment of segmental colonic transit. Gastroenterology 92(1):40–47PubMedGoogle Scholar
  23. 23.
    Chaussade S, Khyari A, Roche H, Garret M, Gaudric M, Couturier D, Guerre J (1989) Determination of total and segmental colonic transit time in constipated patients. Results in 91 patients with a new simplified method. Digest Dis Sci 34(8):1168–1172. doi:10.1007/BF01537263 PubMedGoogle Scholar
  24. 24.
    Meir R, Beglinger C, Dederding JP, Meyer-Wyss B, Fumagalli M, Rowedder A, Turberg J, Brignoli R (1992) Age- and sex-specific standard values of colonic transit time in healthy subjects. Schweiz Med Wochenschr 122(24):940–943PubMedGoogle Scholar
  25. 25.
    Evans JM, Fleming KC, Talley NJ, Schleck CD, Zinsmeister AR, Melton LJIII (1998) Relation of colonic transit to functional bowel disease in older people: a population-based study. J Am Geriatr Soc 46(1):83–87PubMedGoogle Scholar
  26. 26.
    Sadik R, Abrahamsson H, Stotzer PO (2003) Gender differences in gut transit shown with a newly developed radiological procedure. Scand J Gastroenterol 38(1):36–42. doi:10.1080/00365520310004939 PubMedGoogle Scholar
  27. 27.
    Chan YK, Kwan AC, Yuen H, Yeung YW, Lai KC, Wu J, Wong GS, Leung CM, Cheung WC, Wong CK (2004) Normal colon transit time in healthy Chinese adults in Hong Kong. J Gastroenterol Hepatol 19(11):1270–1275. doi:10.1111/j.1440-1746.2004.03492.x PubMedGoogle Scholar
  28. 28.
    Zaslavsky C, da Silveira TR, Maguilnik I (1998) Total and segmental colonic transit time with radio-opaque markers in adolescents with functional constipation. J Pediatr Gastroenterol Nutr 27(2):138–142. doi:10.1097/00005176-199808000-00002 PubMedGoogle Scholar
  29. 29.
    Ke MY, Li RQ, Pan GZ (1990) Gastrointestinal transit time (GITT) in normal Chinese and patients. Zhonghua Nei Ke Za Zhi 29(12):723–726, 765PubMedGoogle Scholar
  30. 30.
    Abrahamsson H, Antov S, Bosaeus I (1988) Gastrointestinal and colonic segmental transit time evaluated by a single abdominal X-ray in healthy subjects and constipated patients. Scand J Gastroenterol Suppl 152:72–80. doi:10.3109/00365528809095938 PubMedGoogle Scholar
  31. 31.
    Turnbull GK, Thompson DG, Day S, Martin J, Walker E, Lennard-Jones JE (1989) Relationships between symptoms, menstrual cycle and orocaecal transit in normal and constipated women. Gut 30(1):30–34. doi:10.1136/gut.30.1.30 PubMedGoogle Scholar
  32. 32.
    van der Sijp JR, Kamm MA, Nightingale JM, Britton KE, Mather SJ, Morris GP, Akkermans LM, Lennard-Jones JE (1993) Radioisotope determination of regional colonic transit in severe constipation: comparison with radio opaque markers. Gut 34(3):402–408. doi:10.1136/gut.34.3.402 PubMedGoogle Scholar
  33. 33.
    Grotz RL, Pemberton JH, Talley NJ, Rath DM, Zinsmeister AR (1994) Discriminant value of psychological distress, symptom profiles, and segmental colonic dysfunction in outpatients with severe idiopathic constipation. Gut 35(6):798–802. doi:10.1136/gut.35.6.798 PubMedGoogle Scholar
  34. 34.
    Stotzer PO, Fjalling M, Gretarsdottir J, Abrahamsson H (1999) Assessment of gastric emptying: comparison of solid scintigraphic emptying and emptying of radiopaque markers in patients and healthy subjects. Digest Dis Sci 44(4):729–734. doi:10.1023/A:1026609808495 PubMedGoogle Scholar
  35. 35.
    Tougas G, Chen Y, Coates G, Paterson W, Dallaire C, Pare P, Boivin M, Watier A, Daniels S, Diamant N (2000) Standardization of a simplified scintigraphic methodology for the assessment of gastric emptying in a multicenter setting. Am J Gastroenterol 95(1):78–86. doi:10.1111/j.1572-0241.2000.01703.x PubMedGoogle Scholar
  36. 36.
    Hermansson G, Sivertsson R (1996) Gender-related differences in gastric emptying rate of solid meals. Digest Dis Sci 41(10):1994–1998. doi:10.1007/BF02093602 PubMedGoogle Scholar
  37. 37.
    Graff J, Brinch K, Madsen JL (2001) Gastrointestinal mean transit times in young and middle-aged healthy subjects. Clin Physiol 21(2):253–259. doi:10.1046/j.1365-2281.2001.00308.x PubMedGoogle Scholar
  38. 38.
    Meier R, Beglinger C, Dederding JP, Meyer-Wyss B, Fumagalli M, Rowedder A, Turberg Y, Brignoli R (1995) Influence of age, gender, hormonal status and smoking habits on colonic transit time. Neurogastroenterol Motil 7(4):235–238PubMedGoogle Scholar
  39. 39.
    Wald A, Van Thiel DH, Hoechstetter L, Gavaler JS, Egler KM, Verm R, Scott L, Lester R (1982) Effect of pregnancy on gastrointestinal transit. Digest Dis Sci 27(11):1015–1018. doi:10.1007/BF01391748 PubMedGoogle Scholar
  40. 40.
    Lawson M, Kern F Jr, Everson GT (1985) Gastrointestinal transit time in human pregnancy: prolongation in the second and third trimesters followed by postpartum normalization. Gastroenterology 89(5):996–999PubMedGoogle Scholar
  41. 41.
    Baron TH, Ramirez B, Richter JE (1993) Gastrointestinal motility disorders during pregnancy. Ann Intern Med 118(5):366–375PubMedGoogle Scholar
  42. 42.
    Hutson WR, Roehrkasse RL, Wald A (1989) Influence of gender and menopause on gastric emptying and motility. Gastroenterology 96(1):11–17PubMedGoogle Scholar
  43. 43.
    Gryback P, Hermansson G, Lyrenas E, Beckman KW, Jacobsson H, Hellstrom PM (2000) Nationwide standardisation and evaluation of scintigraphic gastric emptying: reference values and comparisons between subgroups in a multicentre trial. Eur J Nucl Med 27(6):647–655. doi:10.1007/s002590050558 PubMedGoogle Scholar
  44. 44.
    Bergin AJ, Read NW (1993) The effect of preliminary bowel preparation on a simple test of colonic transit in constipated subjects. Int J Colorectal Dis 8(2):75–77. doi:10.1007/BF00299331 PubMedGoogle Scholar
  45. 45.
    Wagener S, Shankar KR, Turnock RR, Lamont GL, Baillie CT (2004) Colonic transit time—what is normal? J Pediatr Surg 39(2):166–169. doi:10.1016/j.jpedsurg.2003.10.002 (discussion 166–9)PubMedGoogle Scholar
  46. 46.
    Corazziari E, Cucchiara S, Staiano A, Romaniello G, Tamburrini O, Torsoli A, Auricchio S (1985) Gastrointestinal transit time, frequency of defecation, and anorectal manometry in healthy and constipated children. J Pediatr 106(3):379–382. doi:10.1016/S0022-3476(85)80660-0 PubMedGoogle Scholar
  47. 47.
    Bautista Casasnovas A, Varela Cives R, Villanueva Jeremias A, Castro-Gago M, Cadranel S, Tojo Sierra R (1991) Measurement of colonic transit time in children. J Pediatr Gastroenterol Nutr 13(1):42–45PubMedGoogle Scholar
  48. 48.
    Gutierrez C, Marco A, Nogales A, Tebar R (2002) Total and segmental colonic transit time and anorectal manometry in children with chronic idiopathic constipation. J Pediatr Gastroenterol Nutr 35(1):31–38. doi:10.1097/00005176-200207000-00008 PubMedGoogle Scholar
  49. 49.
    Park ES, Park CI, Cho SR, Na SI, Cho YS (2004) Colonic transit time and constipation in children with spastic cerebral palsy. Arch Phys Med Rehabil 85(3):453–456. doi:10.1016/S0003-9993(03)00479-9 PubMedGoogle Scholar
  50. 50.
    Zaslavsky C, De Barros SG, Gruber AC, MacIel AC, Da Silveira TR (2004) Chronic functional constipation in adolescents: clinical findings and motility studies. J Adolesc Health 34(6):517–522PubMedGoogle Scholar
  51. 51.
    Benninga MA, Voskuijl WP, Akkerhuis GW, Taminiau JA, Buller HA (2004) Colonic transit times and behaviour profiles in children with defecation disorders. Arch Dis Child 89(1):13–16PubMedGoogle Scholar
  52. 52.
    McLean RG, Smart RC, Lubowski DZ, King DW, Barbagallo S, Talley NA (1992) Oral colon transit scintigraphy using indium-111 DTPA: variability in healthy subjects. Int J Colorectal Dis 7(4):173–176. doi:10.1007/BF00341215 PubMedGoogle Scholar
  53. 53.
    Bonapace ES, Maurer AH, Davidoff S, Krevsky B, Fisher RS, Parkman HP (2000) Whole gut transit scintigraphy in the clinical evaluation of patients with upper and lower gastrointestinal symptoms. Am J Gastroenterol 95(10):2838–2847. doi:10.1111/j.1572-0241.2000.03195.x PubMedGoogle Scholar
  54. 54.
    Burton DD, Camilleri M, Mullan BP, Forstrom LA, Hung JC (1997) Colonic transit scintigraphy labeled activated charcoal compared with ion exchange pellets. J Nucl Med 38(11):1807–1810PubMedGoogle Scholar
  55. 55.
    Stubbs JB, Valenzuela GA, Stubbs CC, Croft BY, Teates CD, Plankey MW, McCallum RW (1991) A noninvasive scintigraphic assessment of the colonic transit of nondigestible solids in man. J Nucl Med 32(7):1375–1381PubMedGoogle Scholar
  56. 56.
    Krevsky B, Maurer AH, Fisher RS (1989) Patterns of colonic transit in chronic idiopathic constipation. Am J Gastroenterol 84(2):127–132PubMedGoogle Scholar
  57. 57.
    Kamm MA, Lennard-Jones JE, Thompson DG, Sobnack R, Garvie NW, Granowska M (1988) Dynamic scanning defines a colonic defect in severe idiopathic constipation. Gut 29(8):1085–1092. doi:10.1136/gut.29.8.1085 PubMedGoogle Scholar
  58. 58.
    Stivland T, Camilleri M, Vassallo M, Proano M, Rath D, Brown M, Thomforde G, Pemberton J, Phillips S (1991) Scintigraphic measurement of regional gut transit in idiopathic constipation. Gastroenterology 101(1):107–115PubMedGoogle Scholar
  59. 59.
    Cremonini F, Mullan BP, Camilleri M, Burton DD, Rank MR (2002) Performance characteristics of scintigraphic transit measurements for studies of experimental therapies. Aliment Pharmacol Ther 16(10):1781–1790. doi:10.1046/j.1365-2036.2002.01344.x PubMedGoogle Scholar
  60. 60.
    Camilleri M, Colemont LJ, Phillips SF, Brown ML, Thomforde GM, Chapman N, Zinsmeister AR (1989) Human gastric emptying and colonic filling of solids characterized by a new method. Am J Physiol 257(2 Pt 1):G284–G290PubMedGoogle Scholar
  61. 61.
    Krevsky B, Maurer AH, Niewiarowski T, Cohen S (1992) Effect of verapamil on human intestinal transit. Digest Dis Sci 37(6):919–924. doi:10.1007/BF01300391 PubMedGoogle Scholar
  62. 62.
    Scott SM, Knowles CH, Newell M, Garvie N, Williams NS, Lunniss PJ (2001) Scintigraphic assessment of colonic transit in women with slow-transit constipation arising de novo and following pelvic surgery or childbirth. Br J Surg 88(3):405–411. doi:10.1046/j.1365-2168.2001.01699.x PubMedGoogle Scholar
  63. 63.
    Camilleri M, Zinsmeister AR (1992) Towards a relatively inexpensive, noninvasive, accurate test for colonic motility disorders. Gastroenterology 103(1):36–42PubMedGoogle Scholar
  64. 64.
    Lundin E, Karlbom U, Westlin JE, Kairemo K, Jung B, Husin S, Pahlman L, Graf W (2004) Scintigraphic assessment of slow transit constipation with special reference to right- or left-sided colonic delay. Colorectal Dis 6(6):499–505. doi:10.1111/j.1463-1318.2004.00694.x PubMedGoogle Scholar
  65. 65.
    Notghi A, Kumar D, Panagamuwa B, Tulley NJ, Hesslewood SR, Harding LK (1993) Measurement of colonic transit time using radionuclide imaging: analysis by condensed images. Nucl Med Commun 14(3):204–211. doi:10.1097/00006231-199303000-00010 PubMedGoogle Scholar
  66. 66.
    Freedman PN, Goldberg PA, Fataar AB, Mann MM (2006) A comparison of methods of assessment of scintigraphic colon transit. J Nucl Med Technol 34(2):76–81PubMedGoogle Scholar
  67. 67.
    Degen LP, Phillips SF (1996) Variability of gastrointestinal transit in healthy women and men. Gut 39(2):299–305. doi:10.1136/gut.39.2.299 PubMedGoogle Scholar
  68. 68.
    Brophy CM, Moore JG, Christian PE, Egger MJ, Taylor AT (1986) Variability of gastric emptying measurements in man employing standardized radiolabeled meals. Digest Dis Sci 31(8):799–806. doi:10.1007/BF01296046 PubMedGoogle Scholar
  69. 69.
    Notghi A, Mills A, Hutchinson R, Kumar D, Harding LK (1995) Reporting simplified colonic transit studies using radionuclides: clinician friendly reports. Gut 36(2):274–275. doi:10.1136/gut.36.2.274 PubMedGoogle Scholar
  70. 70.
    Madsen JL (1992) Effects of gender, age, and body mass index on gastrointestinal transit times. Digest Dis Sci 37(10):1548–1553. doi:10.1007/BF01296501 PubMedGoogle Scholar
  71. 71.
    Hardy JG, Perkins AC (1985) Validity of the geometric mean correction in the quantification of whole bowel transit. Nucl Med Commun 6(4):217–224. doi:10.1097/00006231-198504000-00005 PubMedGoogle Scholar
  72. 72.
    Krevsky B, Malmud LS, D’Ercole F, Maurer AH, Fisher RS (1986) Colonic transit scintigraphy. A physiologic approach to the quantitative measurement of colonic transit in humans. Gastroenterology 91(5):1102–1112PubMedGoogle Scholar
  73. 73.
    Madsen JL, Jensen M (1989) Gastrointestinal transit of technetium-99m-labeled cellulose fiber and indium-111-labeled plastic particles. J Nucl Med 30(3):402–406PubMedGoogle Scholar
  74. 74.
    Kaufman PN, Richter JE, Chilton HM, Kerr RM, Cowan RC, Gelfand DW, Ott DJ (1990) Effects of liquid versus solid diet on colonic transit in humans. Evaluation by standard colonic transit scintigraphy. Gastroenterology 98(1):73–81PubMedGoogle Scholar
  75. 75.
    Lundin E, Graf W, Garske U, Nilsson S, Maripuu E, Karlbom U (2007) Segmental colonic transit studies: comparison of a radiological and a scintigraphic method. Colorectal Dis 9(4):344–351. doi:10.1111/j.1463-1318.2006.01153.x PubMedGoogle Scholar
  76. 76.
    Roberts JP, Newell MS, Deeks JJ, Waldron DW, Garvie NW, Williams NS (1993) Oral [111In]DTPA scintigraphic assessment of colonic transit in constipated subjects. Digest Dis Sci 38(6):1032–1039. doi:10.1007/BF01295718 PubMedGoogle Scholar
  77. 77.
    Argenyi EE, Soffer EE, Madsen MT, Berbaum KS, Walkner WO (1995) Scintigraphic evaluation of small bowel transit in healthy subjects: inter- and intrasubject variability. Am J Gastroenterol 90(6):938–942PubMedGoogle Scholar
  78. 78.
    Datz FL, Christian PE, Moore J (1987) Gender-related differences in gastric emptying. J Nucl Med 28(7):1204–1207PubMedGoogle Scholar
  79. 79.
    Wald A, Van Thiel DH, Hoechstetter L, Gavaler JS, Egler KM, Verm R, Scott L, Lester R (1981) Gastrointestinal transit: the effect of the menstrual cycle. Gastroenterology 80(6):1497–1500PubMedGoogle Scholar
  80. 80.
    Kamm MA, Farthing MJ, Lennard-Jones JE (1989) Bowel function and transit rate during the menstrual cycle. Gut 30(5):605–608. doi:10.1136/gut.30.5.605 PubMedGoogle Scholar
  81. 81.
    Tota G, Messina M, Meucci D, Piro E, Di Maggio G, Garzi A, Nocentini S, Zingaro P (1998) Use of radionuclides in the evaluation of intestinal transit time in children with idiopathic constipation. Pediatr Med Chir 20(1):63–66PubMedGoogle Scholar
  82. 82.
    Chitkara DK, Bredenoord AJ, Cremonini F, Delgado-Aros S, Smoot RL, El-Youssef M, Freese D, Camilleri M (2004) The role of pelvic floor dysfunction and slow colonic transit in adolescents with refractory constipation. Am J Gastroenterol 99(8):1579–1584. doi:10.1111/j.1572-0241.2004.30176.x PubMedGoogle Scholar
  83. 83.
    Camilleri M, Atanasova E, Carlson PJ, Ahmad U, Kim HJ, Viramontes BE, McKinzie S, Urrutia R (2002) Serotonin-transporter polymorphism pharmacogenetics in diarrhea-predominant irritable bowel syndrome. Gastroenterology 123(2):425–432. doi:10.1053/gast.2002.34780 PubMedGoogle Scholar
  84. 84.
    Cook BJ, Lim E, Cook D, Hughes J, Chow CW, Stanton MP, Bidarkar SS, Southwell BR, Hutson JM (2005) Radionuclear transit to assess sites of delay in large bowel transit in children with chronic idiopathic constipation. J Pediatr Surg 40(3):478–483. doi:10.1016/j.jpedsurg.2004.11.029 PubMedGoogle Scholar
  85. 85.
    Knowles CH, Scott SM, Wellmer A, Misra VP, Pilot MA, Williams NS, Anand P (1999) Sensory and autonomic neuropathy in patients with idiopathic slow-transit constipation. Br J Surg 86(1):54–60. doi:10.1046/j.1365-2168.1999.00994.x PubMedGoogle Scholar
  86. 86.
    Stotzer PO, Abrahamsson H (2000) Human postprandial gastric emptying of indigestible solids can occur unrelated to antral phase III. Neurogastroenterol Motil 12(5):415–419. doi:10.1046/j.1365-2982.2000.00218.x PubMedGoogle Scholar
  87. 87.
    Ponz de Leon M, Iori R, Barbolini G, Pompei G, Zaniol P, Carulli N (1982) Influence of small-bowel transit time on dietary cholesterol absorption in human beings. N Engl J Med 307(2):102–103PubMedCrossRefGoogle Scholar
  88. 88.
    Armbrecht U, Jensen J, Eden S, Stockbrugger R (1986) Assessment of orocoecal transit time by means of a hydrogen (H2) breath test as compared with a radiologic control method. Scand J Gastroenterol 21(6):669–677. doi:10.3109/00365528609011099 PubMedGoogle Scholar
  89. 89.
    Notghi A, Hutchinson R, Kumar D, Tulley N, Harding LK (1994) Use of geometric center and parametric images in scintigraphic colonic transit studies. Gastroenterology 107(5):1270–1277PubMedGoogle Scholar
  90. 90.
    Bouras EP, Camilleri M, Burton DD, Thomforde G, McKinzie S, Zinsmeister AR (2001) Prucalopride accelerates gastrointestinal and colonic transit in patients with constipation without a rectal evacuation disorder. Gastroenterology 120(2):354–360. doi:10.1053/gast.2001.21166 PubMedGoogle Scholar
  91. 91.
    Prather CM, Camilleri M, Zinsmeister AR, McKinzie S, Thomforde G (2000) Tegaserod accelerates orocecal transit in patients with constipation-predominant irritable bowel syndrome. Gastroenterology 118(3):463–468. doi:10.1016/S0016-5085(00)70251-4 PubMedGoogle Scholar
  92. 92.
    Coulie B, Szarka LA, Camilleri M, Burton DD, McKinzie S, Stambler N, Cedarbaum JM (2000) Recombinant human neurotrophic factors accelerate colonic transit and relieve constipation in humans. Gastroenterology 119(1):41–50. doi:10.1053/gast.2000.8553 PubMedGoogle Scholar
  93. 93.
    Turnbull GK, Bartram CI, Lennard-Jones JE (1988) Radiologic studies of rectal evacuation in adults with idiopathic constipation. Dis Colon Rectum 31(3):190–197. doi:10.1007/BF02552545 PubMedGoogle Scholar
  94. 94.
    Kolster J, de Kolter CC, Castro J, Carvajal A (1991) Study of colonic transit time with radiopaque markers in patients with chronic constipation. GE N 45(1):14–22Google Scholar
  95. 95.
    Pemberton JH, Rath DM, Ilstrup DM (1991) Evaluation and surgical treatment of severe chronic constipation. Ann Surg 214(4):403–411. doi:10.1097/00000658-199110000-00005 (discussion 411–3)PubMedGoogle Scholar
  96. 96.
    Surrenti E, Rath DM, Pemberton JH, Camilleri M (1995) Audit of constipation in a tertiary referral gastroenterology practice. Am J Gastroenterol 90(9):1471–1475PubMedGoogle Scholar
  97. 97.
    Walker AR, Walker BF, Richardson BD (1970) Bowel transit times in Bantu populations. BMJ 3(5713):48–49PubMedGoogle Scholar
  98. 98.
    Kuijpers JH (1991) Functional constipation: results of application of the colorectal laboratory. Neth J Surg 43(6):213–217PubMedGoogle Scholar
  99. 99.
    Knowles CH, Nickols CD, Scott SM, Bennett NI, de Oliveira RB, Chimelli L, Feakins R, Williams NS, Martin JE (2001) Smooth muscle inclusion bodies in slow transit constipation. J Pathol 193(3):390–397. doi:10.1002/1096-9896(2000)9999:9999<::AID-PATH797>3.0.CO;2-C PubMedGoogle Scholar
  100. 100.
    Knowles CH, Scott SM, Rayner C, Glia A, Lindberg G, Kamm MA, Lunniss PJ (2003) Idiopathic slow-transit constipation: an almost exclusively female disorder. Dis Colon Rectum 46(12):1716–1717. doi:10.1007/BF02660783 PubMedGoogle Scholar
  101. 101.
    Zarate N, Knowles CH, Newell M, Garvie NW, Gladman MA, Lunniss PJ, Scott SM (2008) In patients with slow transit constipation, the pattern of colonic transit delay does not differentiate between those with and without impaired rectal evacuation. Am J Gastroenterol 103(2):427–434. doi:10.1111/j.1572-0241.2007.01675.x PubMedGoogle Scholar
  102. 102.
    Papadopoulou A, Clayden GS, Booth IW (1994) The clinical value of solid marker transit studies in childhood constipation and soiling. Eur J Pediatr 153(8):560–564. doi:10.1007/BF02190658 PubMedGoogle Scholar
  103. 103.
    Camilleri M, Brown ML, Malagelada JR (1986) Impaired transit of chyme in chronic intestinal pseudoobstruction. Correction by cisapride. Gastroenterology 91(3):619–626PubMedGoogle Scholar
  104. 104.
    Barrow L, Steed KP, Spiller RC, Watts PJ, Melia CD, Davies MC, Wilson CG (1992) Scintigraphic demonstration of lactulose-induced accelerated proximal colon transit. Gastroenterology 103(4):1167–1173PubMedGoogle Scholar
  105. 105.
    Krevsky B, Maurer AH, Malmud LS, Fisher RS (1989) Cisapride accelerates colonic transit in constipated patients with colonic inertia. Am J Gastroenterol 84(8):882–887PubMedGoogle Scholar
  106. 106.
    Kaufman PN, Krevsky B, Malmud LS, Maurer AH, Somers MB, Siegel JA, Fisher RS (1988) Role of opiate receptors in the regulation of colonic transit. Gastroenterology 94(6):1351–1356PubMedGoogle Scholar
  107. 107.
    Park MI, Ferber I, Camilleri M, Allenby K, Trillo R, Burton D, Zinsmeister AR (2006) Effect of atilmotin on gastrointestinal transit in healthy subjects: a randomized, placebo-controlled study. Neurogastroenterol Motil 18(1):28–36. doi:10.1111/j.1365-2982.2005.00726.x PubMedGoogle Scholar
  108. 108.
    Kamm MA, Hawley PR, Lennard-Jones JE (1988) Outcome of colectomy for severe idiopathic constipation. Gut 29(7):969–973. doi:10.1136/gut.29.7.969 PubMedGoogle Scholar
  109. 109.
    Snape WJ Jr (1997) Role of colonic motility in guiding therapy in patients with constipation. Digest Dis 15(Suppl 1):104–111. doi:10.1159/000171625 Google Scholar
  110. 110.
    Knowles CH, Scott M, Lunniss PJ (1999) Outcome of colectomy for slow transit constipation. Ann Surg 230(5):627–638. doi:10.1097/00000658-199911000-00004 PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Bridget R. Southwell
    • 1
    • 2
  • Melanie C. C. Clarke
    • 1
  • Jonathan Sutcliffe
    • 1
  • John M. Hutson
    • 1
    • 2
  1. 1.Surgical Research Group, Gut Motility LaboratoryMurdoch Children’s Research Institute, Royal Children’s HospitalParkvilleAustralia
  2. 2.Department of PaediatricsUniversity of MelbourneMelbourneAustralia

Personalised recommendations