Abstract
Chronic constipation is classified as slow transit constipation (STC), normal transit constipation (NTC), or defecation disorders (DD) in Europe and the United States; however, these classifications have not been adopted in Japan because transit studies are not covered by national health insurance. Ingestion of radiopaque markers (ROM) is a common means of assessing colonic transit time. We assembled a cohort of patients with chronic constipation who underwent colonic transit study (CTS) and specialized anorectal tests. A total of 170 patients ingested a Sitzmarks capsule that contained 20 ROM. An abdominal X-ray was taken 72 hours after ingestion. There was no correlation between the number of retained markers and symptom severity by the Constipation Scoring System (rs = 0.086, p = 0.0237). Among the 170 patients, 64 (38%) were STC defined by ≥ 8 retained markers. Of those patients with STC, 31 had markers confined to the rectosigmoid area. A non-invasive approach such as CTS for identifying DD without the need for specialized anorectal tests would be clinically advantageous, confirm the clinical diagnosis, and enhance the selection of patients for retraining of rectal evacuation.
