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Review
. 2012 Mar;42(2):113-23.
doi: 10.1053/j.semnuclmed.2011.10.004.

Methods for the assessment of small-bowel and colonic transit

Lawrence A Szarka  1 , Michael Camilleri
Affiliations
Review

Methods for the assessment of small-bowel and colonic transit

Lawrence A Szarka et al. Semin Nucl Med. 2012 Mar.

Abstract

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.

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Figures

Figure 1
Figure 1
Ileocolonic transit demonstrating the arrival of radiolabel in the right colon, and movement of isotope from the ascending to the transverse colon in response to meal ingestion at 4 hours. Reproduced from Deiteren A, Camilleri M, Burton D, et al: Effect of meal ingestion on ileocolonic and colonic transit in health and irritable bowel syndrome. Dig Dis Sci 2010;55:384-391.
Figure 2
Figure 2
Effect of the colonic stimulant laxative bisacodyl on colonic transit. Note the acceleration of transit of isotope through the colon with bisacodyl whereas, control treatment is associated with retention of isotope predominantly in the ascending and tortuous transverse colon. Reproduced from Manabe N, Cremonini F, Camilleri M, et al: Effects of bisacodyl on ascending colon emptying and overall colonic transit in healthy volunteers. Aliment Pharmacol Ther 2009;30:930-936.
Figure 3
Figure 3
Wireless motility capsule recording transit in (A) healthy and (B) constipated individuals. Reproduced from Rao SS, Kuo B, McCallum RW, et al: Investigation of colonic and whole-gut transit with wireless motility capsule and radiopaque markers in constipation. Clin Gastroenterol Hepatol 2009;7:537–544
Figure 4
Figure 4
Small bowel and whole gut transit times are prolonged in constipated participants compared to healthy controls. Reproduced from Rao SS, Kuo B, McCallum RW, et al: Investigation of colonic and whole-gut transit with wireless motility capsule and radiopaque markers in constipation. Clin Gastroenterol Hepatol 2009;7:537–544
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