Colonic transit study by radio-opaque markers to investigate constipation: validation of a new protocol for a population with rapid gut transit.

Colonic transit study by radio-opaque markers to investigate constipation: validation of a new protocol for a population with rapid gut transit. Research Abstract Details 

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Colonic transit study by radio-opaque markers to investigate constipation: validation of a new protocol for a population with rapid gut transit. Abstract Text:

Uday C Ghoshal,Dinesh Gupta,Ashok Kumar,Asha Misra,

BACKGROUND: Constipation is a common problem, which may be due to slow transit or faecal evacuation disorders. Though the screening test of colonic transit study using radio-opaque markers given at 0, 24 and 48 hours followed by abdominal X-ray at 72 hours is a good protocol in the West, it is not suitable for Indians who have a rapid gut transit. METHODS: Nine patients with adult Hirschsprung disease, 11 with chronic intestinal pseudo-obstruction diagnosed using standard investigations and 11 healthy subjects were evaluated by colonic transit study using radio-opaque markers (SGmark), 20 each at O, 12 and 24 hours followed by an abdominal X-ray at 36 and 60 hours. The cut-off was determined by using receiver operating characteristic (ROC) curves, and sensitivity, specificity, positive and negative predictive values and diagnostic accuracy were determined. RESULTS: The total number of markers retained in the abdomen and those in the right segment at 36 hours in patients with Hirschsprung disease and chronic intestinal pseudo-obstruction was higher than that in healthy subjects though the number in the left and rectosigmoid segments were comparable. The abdominal X-ray at 60 hours, total number of markers and number in all segments were higher in patients with Hirschsprung disease and chronic intestinal pseudoobstruction than in healthy subjects. The best cut-off by ROC curves at 36 and 60 hours was 30 and 14 markers, respectively. The sensitivity, specificity, positive and negative predictive values, diagnostic accuracy and area under the ROC curve at 36 hours were 90%, 82%, 90%, 82%, 87% and 0.9, respectively; the corresponding values at 60 hours were 95%, 100%, 100%, 92%, 97% and 0.99, respectively. CONCLUSION: Using the proposed protocol, the colonic transit study is able to distinguish patients with specific motility disorders causing constipation such as Hirschsprung disease and chronic intestinal pseudo-obstruction from healthy subjects with reasonable sensitivity and specificity, and shows that an abdominal X-ray at 60 hours is better than one at 36 hours.

Colonic transit study by radio-opaque markers to investigate constipation: validation of a new protocol for a population with rapid gut transit. Publishing Authors By Initials

UC Ghoshal,D Gupta,A Kumar,A Misra,

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Colonic transit study by radio-opaque markers to investigate constipation: validation of a new protocol for a population with rapid gut transit. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: The National medical journal of India

VOLUME: 20

Page Numbers: 225-9

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ISSN: 0970-258X

DAY: 7

MONTH: 02

YEAR: 2008

Colonic transit study by radio-opaque markers to investigate constipation: validation of a new protocol for a population with rapid gut transit. Information

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LANGUAGE: eng

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AFFILIATION: Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, Uttar Pradesh, India. ghoshal@sgpgi.ac.in

Country: India

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MEDLINETA: Natl Med J India

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