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The Use of Colonic Motility and Transit Studies

  • Nancy Baxter
  • John H. Pemberton

Conclusions

Although problems with colonic motility and transit are a common cause of patient complaints, accurate assessment of these complaints remains limited by available assessment tools. Transit studies, including radiopaque markers and colonic scintigraphy, are able to provide a gross assessment of transit and are highly useful in the clinical management of the constipated patient. However, many symptomatic individuals will appear “normal” using one or all of these tests. In addition, these tests do not evaluate the underlying mechanisms for abnormal transit. Further information from research studies using measures of colonic pressure and activity hopefully will improve our understanding of both normal and pathologic colonic motility and transit and the clinical role of these specialized investigations in coloproctological practice.

Keywords

Colonic Transit Colonic Motility Colonic Transit Time Radiopaque Marker Transit Study 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Walter S, Hallbook O, Gotthard R, Bergmark M, and Sjodahl R. A populationbased study on bowel habits in a Swedish community: prevalence of faecal incontinence and constipation. Scand J Gastroenterol. 2002;37:911–6.PubMedCrossRefGoogle Scholar
  2. 2.
    Koch A, Voderholzer WA, Klauser AG, and Muller-Lissner S. Symptoms in chronic constipation. Dis Colon Rectum. 1997;40:902–6.PubMedCrossRefGoogle Scholar
  3. 3.
    Glia A, Lindberg G, Nilsson LH, Mihocsa L, and Akerlund JE. Clinical value of symptom assessment in patients with constipation. Dis Colon Rectum. 1999;42:1401–8.PubMedCrossRefGoogle Scholar
  4. 4.
    Cannon WB. The movements of the intestines studied by means of roentgen rays. Am J Physiol. 1902;6:251–77.Google Scholar
  5. 5.
    Agachan F, Chen T, Pfeifer J, Reissman P, and Wexner SD. A constipation scoring system to simplify evaluation and management of constipated patients. Dis Colon Rectum. 1996;39:681–5.PubMedCrossRefGoogle Scholar
  6. 6.
    Knowles CH, Eccersley AJ, Scott SM, Walker SM, Reeves B, and Lunniss PJ. Linear discriminant analysis of symptoms in patients with chronic constipation. Validation of a new scoring system (KESS). Dis Colon Rectum. 2000;43:1419–26.PubMedCrossRefGoogle Scholar
  7. 7.
    Whitehead WE, Chaussade S, Corazziari E, and Kumar D. Report of an international workshop on management of constipation. Gastroenterol Int. 1999;4:99–113.Google Scholar
  8. 8.
    Koch A, Voderholzer, Klauser AG, Müller-Lissner S. Symptoms in chronic constipation. Dis Colon Rectum. 1997;40:902–6.PubMedCrossRefGoogle Scholar
  9. 9.
    Alvarez WC and Freedlander BL. The rate of progress of food residues through the bowel. JAMA. 1924;83:576–80.Google Scholar
  10. 10.
    Hoelzel F. The rate of passage of inert materials through the digestive tract. Am J Physiol. 1930;92:466–97.Google Scholar
  11. 11.
    Ritchie JA, Truelove SC, Ardran GM, and Tuckey MS. Propulsion and retropulsion of normal colonic contents. Dig Dis. 1971;16:697–704.CrossRefGoogle Scholar
  12. 12.
    Steadman CJ and Phillips SF. Measurement of colonic motor function. In: Kumar DS, Waldron DJ, and Williams NS, editors. Clinical measurement in coloproctology. London: Springer-Verlag; 1991. p. 19–36.Google Scholar
  13. 13.
    Manousos ON, Truelove SC, and Lumsden K. Transit times of food in patients with diverticulosis or irritable colon syndrome and normal subjects. Br Med J. 1967;iii:760–2.CrossRefGoogle Scholar
  14. 14.
    Hinton JM, Lennard-Jones JE, and Young AC. A new method for studying gut transit times using radioopaque markers. Gut. 1969;10:842–7.PubMedGoogle Scholar
  15. 15.
    Cummings JH and Wiggins HS. Transit through the gut measured by analysis of a single stool. Gut. 1976;17:219–23.PubMedGoogle Scholar
  16. 16.
    Cummings JH, Jenkins DJ, and Wiggins HS. Measurement of the mean transit time of dietary residue through the human gut. Gut. 1976;17:210–8.PubMedGoogle Scholar
  17. 17.
    Devroede G. Radiopaque markers and transit. In: Schuster MM, Crowell MD, and Koch KL, editors. Schuster atlas of gastrointestinal motility in health and disease. Hamilton, Canada: BC Decker Inc.; 2002. Table 19.5. p. 265–82.Google Scholar
  18. 18.
    Bouchoucha M, Devroede G, Arhan P, et al. What is the meaning of colorectal transit time measurement? Dis Colon Rectum. 1992;35:773–82.PubMedCrossRefGoogle Scholar
  19. 19.
    Arhan P, Devroede G, Jehannin B, et al. Segmental colonic transit time. Dis Colon Rectum. 1981;24:625–9.PubMedGoogle Scholar
  20. 20.
    Metcalf A. Transit time. In: Smith LE, editor. Practical guide to anorectal testing. New York/Tokyo: Igaku-Shoin; 1990. p. 17–22.Google Scholar
  21. 21.
    Metcalf AM, Phillips SF, Zinsmeister AR, MacCarty RL, Beart RW, and Wolff BG. Simplified assessment of segmental colonic transit. Gastroenterology. 1987;92:40–7.PubMedGoogle Scholar
  22. 22.
    Chaussade S, Roches H, Khyari A, Couturier D, and Guerre J. Mesure du temps de transit colique (TTC): description et validation d’une nouvelle technique. Gastroenterol Clin Biol. 1986;10:385–9.PubMedGoogle Scholar
  23. 23.
    Chaussade S, Gosslein A, Hostein J, Leman M, and Ponsot P. Determination du temps de transit colique (TTC) global et segmentaire dans une population de 96 sujet solontaires sains. Gastroenterol Clin Biol. 1990;14:95–7.PubMedGoogle Scholar
  24. 24.
    Krevsky B, Malmud LS, D’Ercole FF, Maurer AH, and Fisher RS. Colonic transit scintigraphy. A physiologic approach to the quantitative measurement of colonic transit in humans. Gastroenterology. 1986;91:1102–12.PubMedGoogle Scholar
  25. 25.
    Hardy JG, Healey JNC, Lee SW, and Reynolds JR. Gastrointestinal transit of an enteric-coated delayed-release 5-aminosalicylic acid tablet. Aliment Pharmacol Ther. 1987;1:209–16.PubMedCrossRefGoogle Scholar
  26. 26.
    Proano M, Camilleri M, Phillips SF, Brown ML, and Thomforde GM. Transit of solids through the human colon: regional quantification in the unprepared bowel. Am J Physiol. 1990;258:G856–62.PubMedGoogle Scholar
  27. 27.
    Hinds JP, Stoney B, and Wald A. Does gender or the menstrual cycle affect colonic transit? Am J Gastroenterol. 1989;84:123–6.PubMedGoogle Scholar
  28. 28.
    Notghi A, Hutchinson R, Kumar D, Tulley N, and Harding LK. Use of geometric center parametric images in scintigraphic colonic transit studies. Gastroenterology. 1994;107:1270–7.PubMedGoogle Scholar
  29. 29.
    Krevsky B, Malmud LS, D’Ercole F, Maurer AH, and Fisher RS. Colonic transit scintigraphy. A physiologic approach to the quantitative measurement of colonic transit in humans. Gastroenterology. 1986;91:1102–12.PubMedGoogle Scholar
  30. 30.
    Burton DD, Camilleri M, Mullan BP, Forstrom LA, and Hung JC. Colonic transit scintigraphy labeled activated charcoal compared with ion exchange pellets. J Nucl Med. 1997;38:1807–10.PubMedGoogle Scholar
  31. 31.
    Cremonini F, Mullan BP, Camilleri M, Burton DD, and Rank MR. Performance characteristics of scintigraphic transit measurements for studies of experimental therapies. Aliment Pharmacol Ther. 2002;16:1781–90.PubMedCrossRefGoogle Scholar
  32. 32.
    Collins PJ, Horowitz M, Shearman DJC, and Chatterton BE. Correction for tissue attenuation in radionuclide gastric emptying studies: a comparison of a lateral image method and a geometric mean method. Br J Radiol. 1984;57:689–95.PubMedCrossRefGoogle Scholar
  33. 33.
    Notghi A, Hutchinson R, Kumar D, Smith NB, and Harding LK. Simplified method for the measurement of segmental colonic transit time. Gut. 1994;35:976–81.PubMedGoogle Scholar
  34. 34.
    Hagger R, Kumar D, Benson M, and Grundy A. Periodic colonic motor activity identified by 24-h pancolonic ambulatory manometry in humans. Neurogastroenterol Mot. 2002;14:271–8.CrossRefGoogle Scholar
  35. 35.
    Rao SC, Sadeghi P, Beaty J, Kavlock R, and Ackerson K. Ambulatory 24-h colonic manometry in health humans. Am J Physiol Gastrointest Liver Physiol. 2001;280:G629–39.PubMedGoogle Scholar
  36. 36.
    Krevsky B, Maurer AH, Niewiarowski T, and Cohen S. Effect of verapamil on human intestinal transit. Dig Dis Sci. 1992;37:919–24.PubMedCrossRefGoogle Scholar
  37. 37.
    Camilleri M and Zinsmeister AR. Towards a relatively inexpensive noninvasive, accurate test for colonic motility disorders. Gastroenterology. 1992;103:36–42.PubMedGoogle Scholar
  38. 38.
    Soffer EE, Scalabrini P, and Wingate DL. Prolonged ambulant monitoring of human colonic motility. Am J Physiol. 1989;257:G601–6.PubMedGoogle Scholar
  39. 39.
    Sarna S, Latimer P, Campbell D, and Waterfall WE. Electrical and contractile activities of the human rectosigmoid. Gut. 1982;23:698–705.PubMedGoogle Scholar
  40. 40.
    Kerlin P, Zinsmeister A, and Phillips S. Motor responses to food of the ilerum, proximal colon and distal colon of healthy humans. Gastroenterology. 1983;84:762–70.PubMedGoogle Scholar
  41. 41.
    Holdstock DJ, Misiewicz JJ, Smith T, and Rowlands EN. Propulsion (mass movements) in the human colon and its relationship to meals and somatic activity. Gut. 1970;11:91–9.PubMedGoogle Scholar
  42. 42.
    Snape WJ, Wright SH, Battle WM, and Cohen S. The gastrocolic response: evidence for a neural mechanism. Gastroenterology. 1979;77:1235–40.PubMedGoogle Scholar
  43. 43.
    Misiewicz JJ. Human colonic motility. Scand J Gastroenterol. 1984;19Suppl:43–51.Google Scholar
  44. 44.
    Narducci F, Bassotti G, Gaburri M, and Morelli A. Twenty four hour manometric recording of colonic motor activity in healthy man. Gut. 1987;28:17–25.PubMedGoogle Scholar
  45. 45.
    Chauve A, Devroede G, and Bastin E. Intraluminal pressures during perfusion of the human colon in situ. Gastroenterology. 1976;70:336–40.PubMedGoogle Scholar
  46. 46.
    Huizinga JD and Daniel EE. Control of human colonic motor function. Dig Dis Sci. 1986;31:865–77.PubMedCrossRefGoogle Scholar
  47. 47.
    Taylor I, Duthie HL, Smallwood R, and Linkens D. Large bowel myoelectric activity in man. Gut. 1975;16:808–14.PubMedGoogle Scholar
  48. 48.
    Sunshine AG, Perry R, Reynolds JC, Cohen S, and Ouyang A. Colonic slowwave analysis: limitations of usefulness of fast Fourier transform (FFT). Dig Dis Sci. 1989;34:1173–9.PubMedCrossRefGoogle Scholar
  49. 49.
    Schang JC, Hemond M, Herbert M, and Pilote M. Myoelectrical activity and intraluminal flow in human sigmoid colon. Dig Dis Sci. 1986;31:1331–7.PubMedCrossRefGoogle Scholar
  50. 50.
    Parker R, Whitehead WE, and Schuster MM. Pattern recognition program for analysis of colon myoelectric and pressure data. Dig Dis Sci. 1987;32:953–61.PubMedCrossRefGoogle Scholar
  51. 51.
    Dapoigny M, Trolese JF, Bommelaer G, and Tournut R. Myoelectric spiking activity of right colon, left colon and rectosigmoid of healthy humans. Dig Dis Sci. 1988;33:1007–12.PubMedCrossRefGoogle Scholar
  52. 52.
    Rogers J and Misiewicz JJ. Fully automated computer analysis of intracolonic pressures. Gut. 1989;30:634–41.PubMedGoogle Scholar
  53. 53.
    Waldron D, Bowes KI, Kingma YJ, and Cote KR. Colonic and anorectal motility in young women with severe idiopathic constipation. Gastroenterology. 1988;95:1388–94.PubMedGoogle Scholar
  54. 54.
    Whitehead WE and Delvaux M. Standardization of barostat procedures for testing smooth muscle tone and sensory thresholds in the gastrointestinal tract. The Working Team of Glaxo-Wellcome Research, UK. Dig Dis Sci. 1997;42:223–41.Google Scholar

Copyright information

© Springer-Verlag London Limited 2005

Authors and Affiliations

  • Nancy Baxter
    • 1
  • John H. Pemberton
    • 2
  1. 1.University of MinnesotaMinneapolisUSA
  2. 2.Division of Colon and Rectal Surgery, Mayo Graduate School of MedicineMayo Clinic and Mayo FoundationRochesterUSA

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