Colonic Transit Time in Chronic Constipated Patients

ABSTRACT

PURPOSE: In most instances, constipation is considered as idiopathic or functional. The total colonic transit time, traced by radio-opaque markers, makes possible the identification of the colon segment that has the motility alteration that causes constipation. We measured the total and segmental colonic transit time in children with chronic idiopathic constipation and compared the results with those without constipation to determine whether the classification of constipation according to colonic transit time is effective or not on management of functional constipation. METHODS: A study was performed on 15 children aged from 7 to 13, with functional chronic constipation and on 10 without constipation. In all of them the total and segmental colonic transit time were measured with radio-opaque markers. The children ingested 24 markers each on three successive days, and on the fourth day a plain abdominal radiograph was performed. RESULTS: In the nonconstipated children, the total colonic transit time(mean+/-SD) was 30.7+/-10.5 hours, in the right colon 4.7+/-3.3 hours, in the left colon 4.6+/-2.3 hours, and in the rectosigmoid 21.4+/-10.3 hours. In the constipated children, the total colonic transit time was 51.5+/-16.8 hours, in the right colon 13.1+/-6.8 hours, in the left colon 14.3+/-9.8 hours, and in the rectosigmoid 24.1+/-12.6 hours. There was a statistically significant difference(P<0.05) in the total colonic transit time and in both the right and left colon transit times between the constipation and the control group. CONCLUSION: The measurement of total and segmental colonic transit time is a simple method that allows one to distinguish constipation due to colonic dysfunction(right colon and left colon) from constipation due to distal obstruction(rectosigmoid).