Abstract
The objective of this study was to make a qualitative diagnosis of constipation by measuring the colonic transit time using radiopaque markers. Sitzmarks radiopaque markers were ingested by 43 healthy adult volunteers on days 1, 2, and 3. On days 4 and 7, a plain abdominal X-ray was taken and the total colonic transit time and segmental transit times (right colon, left colon, rectosigmoid) were calculated using the method of Metcalf et al. Subjects also completed a questionnaire survey and kept a record of bowel movements (bowel frequency, Bristol Stool Form Scale). Data are presented as median values (h=hour). All male subjects (n=13) were negative for constipation, with a total colonic transit time (TCT) of 7.2h, and segmental transit times for the right colon (RCT), left colon (LCT), and rectosigmoid (RsCT) of 2.4, 3.6, and 2.4h, respectively. A total of 24 female subjects were negative for constipation. In these subjects, the TCT was 31.8h, and the RCT, LCT, RsCT were 4.2, 9.0, and 11.4h, respectively. The remaining six subjects were positive for constipation, with a TCT of 110.4h, and RCT, LCT, RsCT of 30.6, 36.6, and 30.0h, respectively. Stratification of subjects with a TCT of more than 40h enables constipation to be classified as "colonic inertia" (LCT is the longest) or "outlet obstruction" (RsCT is the longest). Since this distinction cannot be made using either bowel frequency or the Bristol Stool Form Scale, it was suggested that a qualitative diagnosis of constipation using radiopaque markers is an effective tool.
