How to interpret a functional or motility test - colon transit study

Eun Ran Kim, Poong-Lyul Rhee, Eun Ran Kim, Poong-Lyul Rhee

Abstract

Measurement of colon transit time is the most basic and primary tool in evaluating disorders of colonic motility. In particular, it is helpful in pathologic diagnosis and for planning management in patients with constipation. Several techniques for measuring colon transit time currently exist. The standard measurement of colon transit time has been performed using radioopaque marker test. The radioopaque marker test is the most widely used method; it is simple to perform as well as being cost effective. But, this technique produces radiation exposure. Radionuclide scintigraphy and wireless motility capsules are other techniques used to measure colon transit time. In radionuclide scintigraphy, the transit of radioisotope is viewed by gamma camera; this approach has an advantage in that it uses minimal radiation and it allows a physiological assessment of gastrointestinal transit. Wireless motility capsules have been validated most recently, but this technique is not useful in Korea. This review presents the techniques used to measure colon transit time and the interpretations provided in different colon transit studies.

Keywords: Colon transit time; Colonic scintigraphy; Radioopaque markers; Wireless motility capsule.

Conflict of interest statement

Conflicts of interest: None.

Figures

Figure 1
Figure 1
Colonic segments in abdominal X-ray. Spinal processes and imaginary lines from fifth lumbar vertebra to right pelvic outlet and left iliac crest, serving as landmarks defined projection zones of right, left and rectosigmoid colon. R, right colon; L, left colon; RS, rectosigmoid colon.
Figure 2
Figure 2
Method of measuring colonic transit: radioisotope-labeled activated charcoal particles delivered in a pH-sensitive methacrylate-coated capsule to the ileocolonic region. Methacrylate dissolves at pH > 6.4, which is achieved in the terminal ileum. The radiolabeled particles traverse the colon in the stool, and the counts in each of 5 regions are used to summarize the location of the weighted average or geometric center at specified times after capsule ingestion (eg, at 24 and 48 hours).
Figure 3
Figure 3
Wireless motility capsule: this figure displays wireless motility capsule profiles from healthy subject who had normal colon transit time as well as normal gastric emptying time. GET, gastric emptying time; SBTT, small bowel transit time; CTT, colon transit time.

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Source: PubMed

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