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Updated: Aug 29, 2026
Gastrointestinal Motility Monitor (GIMM)
Published on: December 1, 2010
[Determination of total and segmental colonic transit time in constipated children]
Shu-cheng Zhang1, Wei-lin Wang, Yu-zuo Bai
1Department of Pediatrics, 2nd Clinical College, China Medical University, Shenyang 110003, China.
Insights
This study establishes normal colonic transit times in Chinese children, revealing significantly prolonged transit in those with constipation. These findings aid in diagnosing and classifying pediatric constipation using transit time and defecography.
Area of Science:
- Pediatric Gastroenterology
- Colorectal Surgery
- Diagnostic Imaging
Background:
- Pediatric constipation is a common clinical issue with varied etiologies.
- Accurate assessment of colonic transit time is crucial for diagnosis and management.
- Understanding normal transit values in specific populations is essential for comparison.
Purpose of the Study:
- To determine the total and segmental colonic transit time in healthy Chinese children.
- To evaluate the diagnostic value of colonic transit time in pediatric constipation.
- To explore the utility of X-ray defecography in identifying anorectal abnormalities in constipated children.
Main Methods:
- A simplified radio-opaque marker method was used to measure total gastrointestinal transit time (TGITT) and segmental colonic transit times (RCTT, LCTT, RSTT).
- Subjects included 33 healthy children (control group) and 25 children with constipation (constipation group).
- X-ray defecography was performed on a subset of constipated patients to assess anorectal function and anatomy.
Main Results:
- Normal values for TGITT, RCTT, LCTT, and RSTT in Chinese children were established.
- Constipated children exhibited significantly longer TGITT, LCTT, and RSTT compared to controls (P < 0.001 for TGITT and RSTT, P < 0.01 for LCTT).
- No significant difference in RCTT was observed between groups; defecography identified rectocele, perineal descent, and puborectal muscle dysfunction.
Conclusions:
- Segmental colonic transit time measurements can help classify constipation into types like slow-transit, outlet obstruction, or mixed.
- X-ray defecography is valuable for detecting anatomical and dynamic anorectal abnormalities.
- Combining gastrointestinal transit time assessment with X-ray defecography offers significant clinical value in elucidating the etiology of pediatric constipation.
Objective:
To determine the total and segmental colonic transit time of normal Chinese children and to explore its value in constipation in children.
Methods:
The subjects involved in this study were divided into 2 groups. One group was control, which had 33 healthy children (21 males and 12 females) aged 2 - 13 years (mean 5 years). The other was constipation group, which had 25 patients (15 males and 10 females) aged 3 - 14 years (mean 7 years) with constipation according to Benninga's criteria. Written informed consent was obtained from the parents of each subject. In this study the simplified method of radio opaque markers was used to determine the total gastrointestinal transit time and segmental colonic transit time of the normal and constipated children, and in part of these patients X-ray defecography was also used.
Results:
The total gastrointestinal transit time (TGITT), right colonic transit time (RCTT), left colonic transit time (LCTT) and rectosigmoid colonic transit time (RSTT) of the normal children were 28.7 +/- 7.7 h, 7.5 +/- 3.2 h, 6.5 +/- 3.8 h and 13.4 +/- 5.6 h, respectively. In the constipated children, the TGITT, LCTT and RSTT were significantly longer than those in controls (92.2 +/- 55.5 h vs 28.7 +/- 7.7 h, P < 0.001; 16.9 +/- 12.6 h vs 6.5 +/- 3.8 h, P < 0.01; 61.5 +/- 29.0 h vs 13.4 +/- 5.6 h, P < 0.001), while the RCTT had no significant difference. X-ray defecography demonstrated one rectocele, one perineal descent syndrome and one puborectal muscle syndrome, respectively.
Conclusion:
The TGITT, RCTT, LCTT and RSTT of the normal children were 28.7 +/- 7.7 h, 7.5 +/- 3.2 h, 6.5 +/- 3.8 h and 13.4 +/- 5.6 h, respectively. With the segmental colonic transit time, constipation can be divided into four types: slow-transit constipation, outlet obstruction, mixed type and normal transit constipation. X-ray defecography can demonstrate the anatomical or dynamic abnormalities within the anorectal area, with which constipation can be further divided into different subtypes, and combined use of the gastrointestinal transit time and X-ray defecography is of clinical importance in exploration of etiology of constipation.
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