Introduction Functional gastrointestinal symptoms are common in the general population. Whole gut transit scintigraphy (WGTS) has been available to investigate patients with functional gastrointestinal symptoms for several years but the technique has not been widely utilised. The aim of this study was to review our experience of doing a liquid-phase WGTS in patients with functional gastrointestinal problems and determine its clinical usefulness.
Methods 56 patients (14 males, mean age 43 years) with functional upper and lower GI symptoms had undergone WGTS using 111In-DTPA in water and a dual-headed gamma camera over a 5-year-period. Gastric emptying (GE) analysis was done using time-activity curves. Small bowel transit (SBT) was determined by the time taken for 10% of total abdominal counts to reach the caecum. Geometric centre (GC) of activity was used to determine colonic transit (CT) time.
Result Presenting symptoms were constipation (n=27), diarrhoea (n=14) and dyspepsia (n=15). WGTS confirmed the diagnosis in 63% patients with constipation. 26% patients with constipation also had a delayed GE and SBT. 30% patients with constipation and 29% with diarrhoea had normal colonic transit. Only 29% of diarrhoea patients seemed to have a rapid CT. More than 50% patients with dyspepsia had normal GE, SBT and CT whereas 40% of them had a delayed CT and SBT.
Conclusion WGTS appears to have a useful role in patients with symptoms of chronic constipation. In patients with diarrhoea, WGTS helps to elucidate its true cause. The procedure helps the clinician explain the symptoms and focus on a particular region of the GI tract for further investigation.
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