Scintigraphic measurement of regional gut transit in idiopathic constipation

In this study, total gut transit and regional colonic transit in patients with idiopathic constipation were measured scintigraphically. Eight patients with severe constipation were studied, none of whom had evidence of abnormal function of the pelvic floor. 99mTc-radiolabeled Amberlite resin particl...

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Veröffentlicht in:Gastroenterology (New York, N.Y. 1943) N.Y. 1943), 1991-07, Vol.101 (1), p.107-115
Hauptverfasser: Stivland, Todd, Camilleri, Michael, Vassallo, Mario, Proano, Maritza, Rath, Doris, Brown, Manuel, Thomforde, George, Pemberton, John, Phillips, Sidney
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container_end_page 115
container_issue 1
container_start_page 107
container_title Gastroenterology (New York, N.Y. 1943)
container_volume 101
creator Stivland, Todd
Camilleri, Michael
Vassallo, Mario
Proano, Maritza
Rath, Doris
Brown, Manuel
Thomforde, George
Pemberton, John
Phillips, Sidney
description In this study, total gut transit and regional colonic transit in patients with idiopathic constipation were measured scintigraphically. Eight patients with severe constipation were studied, none of whom had evidence of abnormal function of the pelvic floor. 99mTc-radiolabeled Amberlite resin particles (average diameter, 1 mm; Sigma Chemical Co., St. Louis, MO) with a mixed meal were used to assess gastric emptying and small bowel transit; similar particles labeled with 111In were ingested in a coated capsule that dispersed in the ileocecal region. These were used to quantify colonic transit. Five healthy volunteers were also studied. Two patients showed delayed gastric emptying and two had slow small bowel transit. Seven of the eight patients had slow colonic transit. In five, delay affected the whole colon (“pancolonic inertia”); in two, transit in the ascending and transverse colon was normal, but solids moved through the left colon slowly. Mean colonic transit was also measured using radiopaque markers; this technique identified the patients with slow transit, as shown by measurements of overall colonic transit by simultaneous scintigraphy. However, estimated transit through the ascending and transverse colons was considerably shorter by the radiopaque marker technique. In conclusion, idiopathic constipation is characterized by either exaggerated reservoir functions of the ascending and transverse colons and/or impairment of propulsive function in the descending colon. Particle size may influence the result of regional colonic transit tests. Transit delays in other parts of the gut suggest that, in some patients, the condition may be a more generalized motor dysfunction.
doi_str_mv 10.1016/0016-5085(91)90466-X
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Eight patients with severe constipation were studied, none of whom had evidence of abnormal function of the pelvic floor. 99mTc-radiolabeled Amberlite resin particles (average diameter, 1 mm; Sigma Chemical Co., St. Louis, MO) with a mixed meal were used to assess gastric emptying and small bowel transit; similar particles labeled with 111In were ingested in a coated capsule that dispersed in the ileocecal region. These were used to quantify colonic transit. Five healthy volunteers were also studied. Two patients showed delayed gastric emptying and two had slow small bowel transit. Seven of the eight patients had slow colonic transit. In five, delay affected the whole colon (“pancolonic inertia”); in two, transit in the ascending and transverse colon was normal, but solids moved through the left colon slowly. Mean colonic transit was also measured using radiopaque markers; this technique identified the patients with slow transit, as shown by measurements of overall colonic transit by simultaneous scintigraphy. However, estimated transit through the ascending and transverse colons was considerably shorter by the radiopaque marker technique. In conclusion, idiopathic constipation is characterized by either exaggerated reservoir functions of the ascending and transverse colons and/or impairment of propulsive function in the descending colon. Particle size may influence the result of regional colonic transit tests. 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Eight patients with severe constipation were studied, none of whom had evidence of abnormal function of the pelvic floor. 99mTc-radiolabeled Amberlite resin particles (average diameter, 1 mm; Sigma Chemical Co., St. Louis, MO) with a mixed meal were used to assess gastric emptying and small bowel transit; similar particles labeled with 111In were ingested in a coated capsule that dispersed in the ileocecal region. These were used to quantify colonic transit. Five healthy volunteers were also studied. Two patients showed delayed gastric emptying and two had slow small bowel transit. Seven of the eight patients had slow colonic transit. In five, delay affected the whole colon (“pancolonic inertia”); in two, transit in the ascending and transverse colon was normal, but solids moved through the left colon slowly. 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identifier ISSN: 0016-5085
ispartof Gastroenterology (New York, N.Y. 1943), 1991-07, Vol.101 (1), p.107-115
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subjects 550601 - Medicine- Unsealed Radionuclides in Diagnostics
Adult
Aged
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
Biological and medical sciences
BODY
Colon - physiology
Colon - physiopathology
CONSTIPATION
Constipation - diagnostic imaging
Constipation - physiopathology
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DIGESTIVE SYSTEM
DIGESTIVE SYSTEM DISEASES
DISEASES
DYNAMIC FUNCTION STUDIES
ELECTRON CAPTURE RADIOISOTOPES
Female
Gastric Emptying
Gastroenterology. Liver. Pancreas. Abdomen
GASTROINTESTINAL TRACT
Gastrointestinal Transit - physiology
HOURS LIVING RADIOISOTOPES
Humans
INDIUM 111
INDIUM ISOTOPES
Indium Radioisotopes
INTERMEDIATE MASS NUCLEI
INTERNAL CONVERSION RADIOISOTOPES
INTESTINES
ISOMERIC NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
LARGE INTESTINE
Male
Medical sciences
Middle Aged
MINUTES LIVING RADIOISOTOPES
NUCLEI
ODD-EVEN NUCLEI
ORGANS
Other diseases. Semiology
PATIENTS
RADIOISOTOPE SCANNING
RADIOISOTOPES
RADIOLOGY AND NUCLEAR MEDICINE
Radionuclide Imaging
SCINTISCANNING
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
SYMPTOMS
Technetium
TECHNETIUM 99
TECHNETIUM ISOTOPES
YEARS LIVING RADIOI
title Scintigraphic measurement of regional gut transit in idiopathic constipation
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