The colon transit time of idiopathic constipation

From July, 1990 to July, 1991, 100 chronically constipated patients with a defecation interval pattern of once more than 4 days and a symptom of abdominal fullness or difficult defecation were chosen as a research group. Two hundred healthy volunteers without defecation problems were chosen randomly as a control group. Colon transit time was checked using the following method. Day 1, ingestion of one sitzmarks (contains 20 radio- opaque markers) at 9:00 AM. Day 2, ingestion of one sitzmarks at 9:00 Am. Day 3, ingestion of one sitzmarks at 9:00AM. Day 4, had an abdominal film (fast film-high KV) at 9:00 AM. Day 7, had an abdominal film (fast film-high KV) at 9:00 AM. The colon transit time was obtained by calculating the numbers of markers on abdominal film. The average of individual segmental colon transit time (x±S.E.) in the controlled group were: right colon-4.2±0.2 hours, left colon-6.4±0.4 hours, rectum and sigmoid-6.3±0.4 hours, total colon- 16.7±0.6 hours. In the research group, total colon and rectum transit times of all cases were longer than the upper limit of total colon and rectum transit time of the control group. Of the right colon transit time, 38% were longer than the upper limit of the control group. Of the left colon, 60% were longer than the upper limit of the control group. Of the sigmoid and rectum, 78% were longer than the upper limit of the control group. From the above results, it was found that 18% patients had prolonged transit time of right and/or left colon, 34% had prolonged rectum and sigmoid transit time and the remaining 48% combined both prolonged right and/or left colon transit time and rectum and sigmoid transit time. Abnormal anorectal function or anatomic deformity of anorectum may be one of the cause to induced prolonged rectum and sigmoid transit time. Further study of anorectal function and anatomy is the next step in the assessment of idiopathic constipation.