Abstract
Patterns of colonic transit were assessed by a simple radioisotopic technique using 3.7 MBq of orally administered [111In]DTPA in 16 control subjects and 37 patients with intractable constipation. Normal subjects showed rapid diffuse spread of isotope through the colon resulting in low activity in all regions of interest (ROI). Activity was lost to feces at 24 hr and was virtually complete by 72 hr (median 94%, range 71–100%). Five constipated patients showed normal transit. Those with colonic inertia (N=26) showed a significantly slowed geometric center of isotope compared to controls (P<0.001), falling below the normal range at 48 hr. Percentage activity curves showed the major site of isotope hold-up to be in the transverse colon and splenic flexure. Other constipated patients (N=6) showed late delay of the geometric center of isotope and accumulation of activity in the descending and rectosigmoid colon, compared to controls, at 96 hr. Oral [111In]DTPA colonic scintigraphy is a useful clinical test in the investigation of constipation.
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References
Wald A, Hinds JP, Caruana BJ: Psychological and physiological characteristics of patients with severe idiopathic constipation. Gastroenterology 97:932–937, 1979
Krevsky B, Somers MB, Maurer AH, Malmud LS: Quantitative measurement of feline colonic transit. Am J Physiol 255:G529-G534, 1988
Krevsky B, Malmud LS, D'Ercole F, Maurer AH, Fisher RS: Colonic transit scintigraphy. Gastroenterology 91:1102–1112, 1986
McClean RG, Smart RC, Gaston-Parry D, Barbagallo S, Baker J, Lyons NR, Bruck CE, King DW, Lubowski DZ, Talley NA: Colon transit scintigraphy in health and constipation using oral iodine-131-cellulose. J Nucl Med 31:985–989, 1990
Proano M, Camilleri M, Phillips SF, Brown ML, Thomforde GM: Transit of solids through the human colon: Regional quantification in the unprepared bowel. Am J Physiol 258:G856-G862, 1990
Stivland T, Camilleri M, Vassallo M, Proano M, Rath D, Brown M, Thomforde G, Pemberton J, Phillips S: Scintigraphic measurement of regional gut transit in idiopathic constipation. Gastroenterology 101:107–115, 1991
Womack NR, Williams NS, Holmfield JHM, Morrison JFB, Simpkins KC: New method for the dynamic assessment of anorectal function in constipation. Br J Surg 69:470–472, 1985
National Radiological Protection Board: Guidance notes for the protection of persons against ionising radiations arising from medical and dental use. London, HMSO, 1988
Roberts JP, Waldron DW, Newell MA, Garvie NW, Williams NS: Comparison of radiopaque marker and radioisotopic assessment of whole bowel transit time in constipated patients. Gut 31:A617, 1990
Krevsky B, Maurer AH, Fisher RS: Patterns of colonic transit in chronic idiopathic constipation. Am J Gastroenterol 84:127–132, 1989
Kuafman PN, Richter JE, Chilton HM, Kerr RM, Cowan RC, Gelfand DW, Ott DJ: Effects of liquid versus solid diet on colonic transit in humans; evaluation by standard colonic transit scintigraphy. Gastroenterology 98:73–81, 1990
Read NW, AL-Janabi, Holgate AM, Barber DC, Edwards CA: Simultaneous measurement of gastric emptying, small bowel residence and colonic filling of a solid meal by the use of the gamma camera. Gut 27:300–308, 1986
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J.P. Roberts was supported by a Medical Research Council grant.
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Roberts, J.P., Newell, M.S., Deeks, J.J. et al. Oral [111In]DTPA scintigraphic assessment of colonic transit in constipated subjects. Digest Dis Sci 38, 1032–1039 (1993). https://doi.org/10.1007/BF01295718
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DOI: https://doi.org/10.1007/BF01295718