Right and left colonic transit after eating assessed by a dual isotopic technique in healthy humans

Propulsion of colonic contents after eating in the whole colon was studied in 15 volunteers by scintigraphy with injection of 111In-diethylenetriamine-pentaacetic acid and 99mTc-sulfur colloid into the colon through a nasogastric tube. The radionuclide was injected into the cecoascending colon (n = 7), the hepatic flexure (n = 6), the splenic flexure (n = 9), and the descending colon (n = 4). Changes of activity in the regions distal from and proximal to the injection points were determined before and after a 1000-kcal meal. Isotopic movements were also analyzed when a simultaneous injection of the two markers in the right and left parts of the colon was achieved (n = 11). During fasting, no significant change of activity was seen. After eating, radioactivity injected into the cecoascending and the hepatic flexure was transferred distally (P less than 0.01 and P = 0.07); radioactivity injected into the splenic flexure was transferred both distally (P = 0.07) and proximally (P less than 0.02); and no significant change of activity was seen proximally from or distally to the descending colon. Both antegrade and retrograde isotopic movements increased after eating (P less than 0.01), but the number of antegrade movements was significantly greater (P less than 0.05). This study confirms the colonic propulsive effect of eating and shows that this response is different in the right and left parts of the colon.