Methods for the Assessment of Small-Bowel and Colonic Transit

doi:10.1053/j.semnuclmed.2011.10.004

Seminars in Nuclear Medicine

Volume 42, Issue 2, March 2012, Pages 113-123

https://doi.org/10.1053/j.semnuclmed.2011.10.004 Get rights and content

Transit assessment of the small intestine and colon is relevant in the study of physiology, pathophysiology, and pharmacodynamics, and there is increasing use of small-bowel and colonic transit measurements in clinical practice as well. The main methods that are applied in clinical practice are substrate-hydrogen breath tests for small-bowel transit and radiopaque markers for colonic transit. Over the past 2-3 decades, scintigraphy has become the preferred standard in research studies, particularly for studies of pathophysiology and pharmacodynamics. New approaches include experimental stable isotope measurement of orocecal transit and the recently approved method using a wireless motility capsule that is validated as an accurate measurement of small-bowel and colonic transit.

Section snippets

Barium Contrast Studies

The earliest and most readily available method for assessing gastrointestinal transit is contrast radiography. Barium is an imperfect substitute for intestinal chyme because it is inert and, therefore, it does not initiate events induced by the biochemical components of food. Barium also has a greater density than water, and it is hypoosmolar compared with food. Nevertheless, barium contrast studies are immensely helpful in patients with suspected motility disorders to rule out mechanical

Radiopaque Marker

Colonic transit studies are used to evaluate total and segmental colonic transit times. Radiopaque markers can be obtained commercially.

Several different methods to measure colonic transit with radiopaque markers have been described.80, 81, 82 The method that is perhaps the simplest and involves the least amount of radiation exposure is the method reported by Hinton et al.⁸⁰ This involves the ingestion of a gelatin capsule containing 24 radiopaque 4.5-mm rings and performing a single plain

Acknowledgments

The authors thank Mrs Cindy Stanislav for excellent secretarial support. M.C. is supported in part by grants RO1-DK-1RC1-DK086182, R01-DK-079866, and RO1-DK-67071 from National Institutes of Health.

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Methods for the Assessment of Small-Bowel and Colonic Transit

Section snippets

Barium Contrast Studies

Radiopaque Marker

Acknowledgments

Gastroenterology

Eur J Radiol

Clin Radiol

Am J Gastroenterol

Gastroenterology

Biochim Biophys Acta

Dig Liver Dis

Am J Surg

Am J Gastroenterol

Gastroenterology

Semin Nucl Med

Mayo Clin Proc

Gastroenterology

Gastroenterology

Gastroenterology

Gastroenterology

Gastroenterology

Clin Gastroenterol Hepatol

Gastroenterology

Gastroenterol Clin North Am

Gastroenterology

Gastroenterology

Gastroenterology

The movements and innervation of the small intestine

J Physiol

Intestinal tone and gas motion

Neurogastroenterol Motil

Gastrointestinal Radiology

Transit time through the small intestine: Roentgenologic study on normal variability

Acta Radiol Suppl

Evaluation of intramuscular ceruletide for shortening small bowel transit time

Gastrointest Radiol

Small intestine transit time in the normal small bowel study

AJR

Laxatives prior to small bowel follow-through: Are they necessary for a rapid and good-quality examination?

Gastrointest Radiol

The small bowel follow-through: Time to sit up

Clin Radiol

Use of effervescent agents in small bowel meal examination

Clin Radiol

Modifications to the gas-enhanced small bowel barium follow-through using Gastrografin and compression

Clin Radiol

The use of metoclopramide for the small bowel meal examination: Pre-procedural versus peri-procedural oral administration

Br J Radiol

Action of metoclopramide on gastric emptying and small bowel transit time

Gut

Investigation of small bowel transit time in man utilizing pulmonary hydrogen (H2) measurements

J Lab Clin Med

Repeatability of lactulose hydrogen breath test in subjects with normal or prolonged orocecal transit

Dig Dis Sci

Hydrogen breath test assessment of orocecal transit time: comparison with barium meal study

Am J Gastroenterol

Combined oro-caecal scintigraphy and lactulose hydrogen breath testing demonstrate that breath testing detects oro-caecal transit, not small intestinal bacterial overgrowth in patients with IBS

Gut

Lactulose hydrogen breath test in orocecal transit assessmentCritical evaluation by means of scintigraphic method

Dig Dis Sci

The effect of different dosages of guar gum on gastric emptying and small intestinal transit of a consumed semisolid meal

J Am Coll Nutr

Effect of drugs on oro-caecal transit time assessed by the lactulose/breath hydrogen method

Eur J Clin Pharmacol

Gut motility and transit changes in patients receiving long-term methadone maintenance

J Clin Pharmacol

The safety and efficacy of oral methylnaltrexone in preventing morphine-induced delay in oral-cecal transit time

Clin Pharmacol Ther

Effect of a tricyclic antidepressant on small intestinal motility in health and diarrhea-predominant irritable bowel syndrome

Dig Dis Sci

Effect of clonidine on gallbladder contraction and small bowel transit time in insulin-treated diabetics

Am J Gastroenterol

Breath hydrogen test after a bean meal demonstrates delayed oro-cecal transit time in children with chronic constipation

J Pediatr Gastroenterol Nutr

Tropical sprue is associated with contamination of small bowel with aerobic bacteria and reversible prolongation of orocecal transit time

J Gastroenterol Hepatol

Orocecal transit time in patients with functional dyspepsia

J Clin Gastroenterol

Bacterial overgrowth, intestinal transit, and nutrition after total gastrectomyComparison of a jejunal pouch with Roux-en-Y reconstruction in a prospective random study