Development of colonic transit time and ultrasound imaging tools as objective indicators for assessing abnormal defecation associated with food intake: a narrative review based on previous scientific knowledge

Abstract Background Functional gastrointestinal disorders (FGIDs) involve chronic or persistent gastrointestinal symptoms. Laboratory tests show no organic lesions, and the symptoms are due to dysfunction. The most typical FGID is irritable bowel syndrome (IBS). In IBS patients, defecation disorders are common and have adverse effects on daily life. The proper evaluation and analysis of colonic transit are important for the management of defecation disorders in IBS patients. In addition, dietary intake and lifestyle affect colonic transit. An accurate assessment of such factors can guide management, leading to improvements in colonic transit and the resolution of defecation disorders. Main topic The Rome IV diagnostic criteria for IBS are based on subjective symptoms, which must be communicated and explained by the patient, limiting their application. Colonic transit time and ultrasonography are objective tools that can be used to diagnose IBS. In particular, previous studies used colonic transit to accurately distinguish between constipation and normal stool passage and to assess delayed gastrointestinal motility. Diet and lifestyle modifications can improve colonic transit and ameliorate bowel dysfunction. Conclusion Colonic transit can be improved by modifying lifestyle factors. Defecation disorders in IBS patients may be resolved by focusing on such factors. In the future, methods of visualizing defecation disorders due to impaired gastrointestinal motility and objective indicators of the associated abdominal symptoms need to be investigated.

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Longer colonic transit time is associated with laxative and drug use, lifestyle factors, and symptoms of constipation

Acta Radiologica Open ◽

10.1177/2058460118807232 ◽

2018 ◽

Vol 7 (10) ◽

pp. 205846011880723 ◽

Cited By ~ 1

Author(s):

Johan Bohlin ◽

Erik Dahlin ◽

Julia Dreja ◽

Bodil Roth ◽

Olle Ekberg ◽

...

Keyword(s):

Abdominal Pain ◽

Drug Use ◽

Transit Time ◽

Gastrointestinal Symptoms ◽

Coffee Consumption ◽

Lifestyle Factors ◽

Colonic Transit ◽

Stool Frequency ◽

Colonic Transit Time ◽

Female Sex

Background Gastrointestinal symptoms and changes in colonic transit time (CTT) are common in the population. Purpose To evaluate consecutive patients who had been examined for CTT, along with completion of a diary about laxative and drug use, lifestyle factors, and gastrointestinal symptoms, to identify possible associations with longer or prolonged CTT. Material and Methods A total of 610 consecutive patients had undergone the radiopaque marker method with an abdominal X-ray for clinical purposes. The patients had completed a diary regarding medical treatment, lifestyle factors, stool habits, and their perceived constipation and abdominal pain during the examination period. The associations between CTT and laxative use, lifestyle factors, stool habits, and symptoms were calculated by logistic regression. Results Women had longer CTT (2.5 [1.6–3.9] vs. 1.7 [1.1–3.0] days, P < 0.001), lower weekly stool frequency (6 [3–10] vs. 8 [5–12], P = 0.001), and perceived more constipation ( P = 0.025) and abdominal pain ( P = 0.001) than men. High coffee consumption ( P = 0.045), bulk-forming ( P = 0.007) and osmotic ( P = 0.001) laxatives, and lower stool frequency, shaped stool, and perceived constipation ( P for trend < 0.001) were associated with longer CTT. In total, 382 patients (63%) were treated with drugs affecting motility. In the 228 patients without drug treatment, longer CTT was associated with female sex and smoking, and lower frequency of symptoms and prolonged CTT were observed compared to patients using drugs. Tea, alcohol, and abdominal pain did not associate with CTT. Conclusions Female sex, coffee, smoking, drug use, infrequent stools, shaped stool, and perception of constipation are associated with longer or prolonged CTT.

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Effects of 28-Day Bifidobacterium animalis subsp. lactis HN019 Supplementation on Colonic Transit Time and Gastrointestinal Symptoms in Adults With Functional Constipation

The American Journal of Gastroenterology ◽

10.14309/00000434-201710001-00459 ◽

2017 ◽

Vol 112 ◽

pp. S243

Author(s):

Alvin Ibarra ◽

Mathilde Latreille-Barbier ◽

Yves Donazzolo ◽

Xavier Pelletier ◽

Arthur Ouwehand

Keyword(s):

Transit Time ◽

Gastrointestinal Symptoms ◽

Functional Constipation ◽

Colonic Transit ◽

Colonic Transit Time ◽

Bifidobacterium Animalis

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Effects of 28-day Bifidobacterium animalis subsp. lactis HN019 supplementation on colonic transit time and gastrointestinal symptoms in adults with functional constipation: A double-blind, randomized, placebo-controlled, and dose-ranging trial

Gut Microbes ◽

10.1080/19490976.2017.1412908 ◽

2018 ◽

Vol 9 (3) ◽

pp. 236-251 ◽

Cited By ~ 17

Author(s):

Alvin Ibarra ◽

Mathilde Latreille-Barbier ◽

Yves Donazzolo ◽

Xavier Pelletier ◽

Arthur C. Ouwehand

Keyword(s):

Transit Time ◽

Gastrointestinal Symptoms ◽

Functional Constipation ◽

Colonic Transit ◽

Colonic Transit Time ◽

Double Blind ◽

Bifidobacterium Animalis ◽

Dose Ranging

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Colonic Transit Time Evaluation in Patients with Functional Constipation

Galen Medical Journal ◽

10.31661/gmj.v1i2.25 ◽

2013 ◽

Vol 1 (2) ◽

pp. 48-52

Author(s):

Masoud Taheri ◽

Rahmatollah Rafiei ◽

Zahra Torabi ◽

Ali Toghiani ◽

Sina Taherzadeh

Keyword(s):

Transit Time ◽

Gastrointestinal Symptoms ◽

Functional Constipation ◽

Colonic Transit ◽

Colonic Transit Time ◽

P Value ◽

Cross Sectional ◽

Colon Transit Time ◽

Significant Difference ◽

Colon Transit

Introduction: Functional constipation is one of the most common gastrointestinal symptoms which could affect patients’ quality of life. The colonic transit time test could be used for determining functional constipation subtypes. The aim of our study was to determine the abnormalities of the subtypes of functional constipation using CTT. Methods and Materials: This cross-sectional study was performed on 85 patients in 2011 in Shariaaty Hospital, Isfahan. All the patients received 60 radio-opaque markers, and they underwent radiological evaluation 5 days afterwards. Functional constipation was determined according to the distribution of the markers in the colon. Result: The samples consisted of 24 males and 61 females at a mean age of 42.7 ± 16.28 years. The colonic transit time results showed that 71 patients had normal transit time, 6 had a composite type, 5 had slow transit, and 3 had pelvic delay. There was no significant difference between sex and colon transit time types (P value =0.32). The mean colon transit time in our study was 51.8 ± 16.3 hours. Conclusion: Functional constipation patients should undergo CTT, especially those who use maneuvers for defecation and those who need more time for defecation.[GMJ. 2012;1(2):48-52]

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Efficacy of Polydextrose Supplementation on Colonic Transit Time, Bowel Movements, and Gastrointestinal Symptoms in Adults: A Double-Blind, Randomized, Placebo-Controlled Trial

Nutrients ◽

10.3390/nu11020439 ◽

2019 ◽

Vol 11 (2) ◽

pp. 439 ◽

Cited By ~ 1

Author(s):

Alvin Ibarra ◽

Tetyana Pelipyagina ◽

Matthew Rueffer ◽

Malkanthi Evans ◽

Arthur Ouwehand

Keyword(s):

Transit Time ◽

Lifestyle Modification ◽

Controlled Trial ◽

Gastrointestinal Symptoms ◽

Colonic Transit ◽

Colonic Transit Time ◽

X Rays ◽

Double Blind ◽

Bowel Movements ◽

Secondary Outcomes

The addition of fiber is one of the most important dietary means to relieve constipation through lifestyle modification. Polydextrose (PDX) has been reported in several studies to increase fecal bulk, soften stools, and increase the number of defecations. However, there are few studies on the effect of PDX on colonic transit time (CTT). Therefore, the aim of this study was to demonstrate the effect of PDX on CTT and other aspects of gastrointestinal function during two weeks (Day 1 to Day 14), preceded by a 2-week run-in period (Day -14 to Day -1). A total of 192 adults who were diagnosed with functional constipation per Rome III criteria were recruited for the study. Participants were randomized equally into 4 groups (12 g, 8 g, or 4 g of PDX or placebo per day). The primary endpoint was CTT, assessed using radio-opaque markers and abdominal X-rays on Day 0, the baseline; and Day 15, the end of the intervention. Secondary outcomes that were measured using inventories were the patient assessment of constipation symptoms and quality of life, bowel function index, relief of constipation, bowel movement frequency (BMF), stool consistency, degree of straining, and proportion of bowel movements. Ancillary parameters and harms were also evaluated. The recruited population was not sufficiently constipated (e.g., baseline values for CTT and BMF of 42 h and 8.7 BMF/week, respectively). Despite this limitation, our results demonstrated an increased number of bowel movements when supplemented with PDX at a dosage of 12 g per day for 2 weeks. This dosage also consistently improved the secondary outcomes that were measured using inventories at Day 15, compared with the baseline. No serious or significant adverse events were reported during the study.

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