Constipation other imaging findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]

Overview

Barium enema may be helpful in diagnosing underlying diseases of constipation. Findings on a barium enema suggestive of constipation are redundant sigmoid colon, megacolon, megarectum, extrinsic compression, and intraluminal masses. Defecography may be helpful in diagnosing underlying diseases causing constipation. Findings on a defecography suggestive of constipation are poor activation of levator ani muscle, prolonged retention or inability to expel the barium, absence of a stripping wave in the rectum, mucosal intussusceptions, or rectocele. The transit time of the colon can be measured by means of various methods, include radiopaque marker ingestion, radioisotope and scintigraphy study, and wireless motility capsule.

Other Imaging Findings

Barium enema of intestinal tract-By Glitzy queen00 (Own work), via English Wikipedia [Public domain][1]

Barium enema

  • Barium enema is found to be inefficient for diagnosing organic lesions in colorectal portions of patients with constipation.[4]

Defecography

Colorectal transit study

Radiopaque markers

  • Radiopaque markers are plastic beads or rings are been contained in a edible capsule.
  • There are 20-50 rings in each capsule. There are two methods of diagnosis:
  • On the day 5, more than 20% rings (more than 6 markers) remaining in the bowels is diagnostic of delayed colonic transit.[7]
Wireless motility capsule (WMC) finding thoughout the GI tract, via https://openi.nlm.nih.gov

Colonic transit scintigraphy

Wireless motility capsule (WMC)

  • Wireless motility capsule (WMC) is a non-invasive method for determining not only colonic transit time, but also the primary characteristics of gastric emptying and small intestine transit time.[10]
  • WMC measures the temperature (T), pH, and pressure (P) changes during the gut passage. Therefore, transit time can be studied in each part of gastrointestinal tract, regarding different levels of T, pH, and P.
  • WMC is proved to have a reasonable sensitivity in detecting any motility disorder or other underlying diseases causing constipation.[11]

References

  1. <"https://commons.wikimedia.org/wiki/File%3AHuman_intestinal_tract%2C_as_imaged_via_double-contrast_barium_enema.jpg">via Wikimedia Commons
  2. 2.0 2.1 Rao SS, Meduri K (2011). "What is necessary to diagnose constipation?". Best Pract Res Clin Gastroenterol. 25 (1): 127–40. doi:10.1016/j.bpg.2010.11.001. PMC 3063397. PMID 21382584.
  3. Gerson DE, Lewicki AM, McNeil BJ, Abrams HL, Korngold E (1979). "The barium enema; evidence for proper utilization". Radiology. 130 (2): 297–301. doi:10.1148/130.2.297. PMID 104358.
  4. Patriquin H, Martelli H, Devroede G (1978). "Barium enema in chronic constipation: is it meaningful?". Gastroenterology. 75 (4): 619–22. PMID 710831.
  5. 5.0 5.1 Diamant NE, Kamm MA, Wald A, Whitehead WE (1999). "AGA technical review on anorectal testing techniques". Gastroenterology. 116 (3): 735–60. PMID 10029632.
  6. Savoye-Collet C, Koning E, Dacher JN (2008). "Radiologic evaluation of pelvic floor disorders". Gastroenterol. Clin. North Am. 37 (3): 553–67, viii. doi:10.1016/j.gtc.2008.06.004. PMID 18793996.
  7. Kim ER, Rhee PL (2012). "How to interpret a functional or motility test - colon transit study". J Neurogastroenterol Motil. 18 (1): 94–9. doi:10.5056/jnm.2012.18.1.94. PMC 3271260. PMID 22323993.
  8. Stivland T, Camilleri M, Vassallo M, Proano M, Rath D, Brown M, Thomforde G, Pemberton J, Phillips S (1991). "Scintigraphic measurement of regional gut transit in idiopathic constipation". Gastroenterology. 101 (1): 107–15. PMID 2044899.
  9. Maurer AH, Parkman HP (2006). "Update on gastrointestinal scintigraphy". Semin Nucl Med. 36 (2): 110–8. doi:10.1053/j.semnuclmed.2005.12.003. PMID 16517233.
  10. Rao SS, Kuo B, McCallum RW, Chey WD, DiBaise JK, Hasler WL, Koch KL, Lackner JM, Miller C, Saad R, Semler JR, Sitrin MD, Wilding GE, Parkman HP (2009). "Investigation of colonic and whole-gut transit with wireless motility capsule and radiopaque markers in constipation". Clin. Gastroenterol. Hepatol. 7 (5): 537–44. PMID 19418602.
  11. Lee, Allen; Michalek, Whitney; Wiener, Stephen M.; Kuo, Braden (2010). "T1067 Clinical Impact of a Wireless Motility Capsule – A Retrospective Review". Gastroenterology. 138 (5): S-481. doi:10.1016/S0016-5085(10)62222-6. ISSN 0016-5085.