RT Journal Article
SR Electronic
T1 Dynamic scanning defines a colonic defect in severe idiopathic constipation.
JF Gut
JO Gut
FD BMJ Publishing Group Ltd and British Society of Gastroenterology
SP 1085
OP 1092
DO 10.1136/gut.29.8.1085
VO 29
IS 8
A1 M A Kamm
A1 J E Lennard-Jones
A1 D G Thompson
A1 R Sobnack
A1 N W Garvie
A1 M Granowska
YR 1988
UL http://gut.bmj.com/content/29/8/1085.abstract
AB A technique is described in which a chemical stimulus applied to the mucosa of the right colon is used to assess colonic motor function. Peroral intubation of the right colon was achieved using a fine polyvinylchloride (PVC) tube. Bisacodyl was used to initiate colonic motor activity, and colonic transit was monitored using 99mTc-DPTA and a gamma camera. In normal subjects there was rapid movement of the radiopharmaceutical from the right colon to the rectum. In patients with severe idiopathic constipation, a spectrum of colonic abnormality was observed from slow transit involving the rectum and sigmoid only to slow transit involving the whole colon. The hepatic flexure to rectum transit time for the 'head of the isotope column' in normals ranged from 1-10 minutes (mean 5.3 minutes), whereas in patients the transit time was 14-25 minutes in four patients and radioisotope did not reach the rectum by two hours in three other patients (controls v patients, p less than 0.01). Patients also showed relatively impaired transport of the isotope 'mass'. This technique has shown that the normal colon is capable of rapid effective transport in response to a standard stimulus, and that patients with severe idiopathic constipation have a definable colonic motor disorder.