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Role of Colon Transit Study in Refractory Constipation
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| Author:
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PENTAKOTA KIRANMAYI, YELLAPU RADHA KRISHNA, PRASANTHI CHERUKURI, SUMERA SALOMI SOUDAGAR
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| Abstract:
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Back ground: Refractory Constipation is a prevalent problem in day to day practice. There are many secondary
causes like drug-related, hypothyroidism, diabetes, which can be treated. However, primary refractory
constipation is complex and difficult to treat as it can be due to normal transit, slow transit, or outlet obstruction.
Objective: The role of colon transit time in patients with primary refractory constipation is examined in this
study.
Materials and Methods: The study was done in a Tertiary care Gastro center in the north coastal part of
south India. Fifty three Consecutive primary refractory constipation patients were enrolled after excluding
secondary causes from February 2018 to March 2019. The colon transit research was carried out using
indigenous sitz makers in accordance with a standardized Indian protocol, in which 60 markers (20 each provided
at intervals of 0, 12, and 24 hours) were administered and abdominal X-rays were taken at 36 and 60 hours.
Slow transit was taken if more than 30 and 14 markers remained in the colon at 36 and 60 hours X-Ray,
respectively. Outlet obstruction was taken when there was a significant hold up of markers in the pelvis.
Results: Out of fifty three patients selected based on the inclusion criteria, 31 were males and 22 were females.
The age ranges from 20 to 64 years with a mean age group 39.7±2.3 years. After using indigenously prepared
radio-opaque sitz markers to perform a colonic transit, it was noticed that 15 patients had sluggish transit, 12
patients had outlet obstruction, and 26 patients had regular transit time. The findings were statistically
insignificant. The results of present study revealed, at 36 hours of X-ray >55 ± 5% markers were identified in
right,transverse and left segment of the colon in slow transit patients, <10 ± 5% markers in normal transit cases
and >50 ± 5% markers in rectosigmoid segment whereas at 60 hours of X-ray >23 ± 3% markers were identified
in right, and left segments in slow transit patients, hardly any in normal transit cases and >45 ± 5% markers in
rectosigmoid segment.
Conclusions: A colon transit study using radio-opaque markers is a simple technique for objectively identifying
the various primary refractory constipation groups. The exact type of abnormality can be treated appropriately
to yield the best results.
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| Keyword:
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Refractory Constipation, Colon transit study, Rome III Criteria, radio-opaque markers.
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| EOI:
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| DOI:
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https://doi.org/10.31838/ijpr/2021.13.02.449
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| Download:
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