Cited by 928Gastrointestinal motility and disordersPelvic floor disorders treatmentsIntestinal Malrotation and Obstruction Disorders

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Simplified assessment of segmental colonic transit

Metcalf, Amanda M., Phillips, Sidney F., Zinsmeister, Alan R., MacCarty, Robert L., Beart, Robert W., Wolff, Bruce G.·1987·Gastroenterology

DOI 10.1016/0016-5085(87)90837-7

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Abstract

Transit times of radiopaque markers through the human gut were measured by published techniques and compared with a simplified method. Three sets of distinctive markers were ingested by 24 healthy persons on 3 successive days. In the first part of the study, daily abdominal x-rays were taken and individual stools were collected for radiography. Mouth-to-anus transits were assessed from the fecal output of markers and mean colonic and segmental colonic transits were calculated from the daily radiographs. These established methods were then compared with estimates of total colonic and segmental transits based on a single abdominal film, taken on the fourth day. The single-film technique correlated well with values obtained from the previous, but more inconvenient, methods. Using the simpler approach, colonic transit was assessed in 49 additional healthy subjects, for a total group of 73. Total colonic transit was 35.0 +/- 2.1 h (mean +/- SE); segmental transits was 11.3 +/- 1.1 h for the right colon, 11.4 +/- 1.4 h for the left colon, and 12.4 +/- 1.1 h for the rectosigmoid. Men had significantly shorter transits for the whole colon than did women (p less than 0.05), and this difference was apparent to some extent in the right (p = 0.06) and left colon (p = 0.07) but not in the rectosigmoid. Age did not influence transit significantly nor did a small dose of supplemental fiber. The technique is simple, convenient for clinical usage, and reduces the exposure to radiation to acce…

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Research works printed but not linked: 16

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“Statistical Analysis TT was calculated according to the Metcalf formula (8).”
BackgroundMethodInfluential
Effect of bowel cleansing on colonic transit in constipation due to slow transit or evacuation disorder
Sloots, C. E. J., & Felt-Bersma, R. J. F. (2002) · Neurogastroenterology & Motility · doi:10.1046/j.1365-2982.2002.00304.x · Cited by 31
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Pathophysiology of chronic childhood constipation: functional and morphological evaluation by anorectal manometry and endosonography and colonic transit study.
Keshtgar, A., Ward, H. C., & Clayden, G. (2013) · Journal of Pediatric Surgery · doi:10.1016/j.jpedsurg.2012.08.037 · Cited by 31
Early recognition of pelvic floor dyssynergia and colorectal assessment in Parkinson's disease associated with bowel dysfunction
Wang, C.-P., Sung, W., Wang, C.-C., & Tsai, P.-Y. (2013) · Colorectal Disease · doi:10.1111/codi.12105 · Cited by 31
Long-term Follow-up of the Jinling Procedure for Combined Slow-Transit Constipation and Obstructive Defecation
Li, N., Jiang, J., Feng, X., Ding, W., Liu, J., & Li, J. (2012) · Diseases of the Colon & Rectum · doi:10.1097/dcr.0b013e318273a182 · Cited by 35
“There were 2 main principles for simultaneous assessment of total and segmental colonic transit time studies: 1) to follow the transit of the radio-labeled particles with either repeated examinations of the transit of a bolus along the colon(28) or 2) daily administration of the particles over a longer period followed…”
Background
Accuracy in assessment of colonic transit time with particles: how many markers should be used?
Abrahamsson, H., & Antov, S. (2010) · Neurogastroenterology & Motility · doi:10.1111/j.1365-2982.2010.01543.x · Cited by 29
Colonic antigen administration induces significantly higher humoral levels of colonic and vaginal IgA, and serum IgG compared to oral administration.
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Pathophysiology, diagnosis and current management of chronic constipation
Wald, A. M. (2006) · Nature Clinical Practice Gastroenterology & Hepatology · doi:10.1038/ncpgasthep0406 · Cited by 35
Differences Between Male and Female Responses to Painful Thermal and Mechanical Stimulation of the Human Esophagus
Pedersen, J., Reddy, H., Funch-Jensen, P. M., Arendt‐Nielsen, L., Gregersen, H. N., & Drewes, A. M. (2004) · Digestive Diseases and Sciences · doi:10.1023/b:ddas.0000037789.25734.06 · Cited by 27
Loperamide suppositories in an adolescent with childhood-onset functional non-retentive fecal soiling.
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“Total colonic transit time measurement, using the Metcalf method (7), was 33.”
Method
Colectomy for severe slow-transit constipation in strictly selected patients.
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Scintigraphic determination of gastrointestinal transit times. A comparison with breath hydrogen and radiologic methods.
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Do the Symptom-Based, Rome Criteria of Irritable Bowel Syndrome Lead to Better Diagnosis and Treatment Outcomes? The Con Argument
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SLOW TRANSIT CONSTIPATION
Bharucha, A. E., & Phillips, S. F. (2001) · Gastroenterology Clinics of North America · doi:10.1016/s0889-8553(05)70168-0 · Cited by 60
Self-citation
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Prokesch, R. W., Breitenseher, M., Kettenbach, J., Herbst, F., Maier, A., Lechner, G. L., & Mahieu, P. (1999) · European Journal of Radiology · doi:10.1016/s0720-048x(99)00037-6 · Cited by 30
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Oh, H.-G., Lee, H.-Y., Seo, M.-Y., Kang, Y.-R., Kim, J.-H., Park, J.-W., Kim, O., Back, H., Kim, S.-Y., Oh, M.-R., et al. (2011) · Laboratory Animal Research · doi:10.5625/lar.2011.27.4.275 · Cited by 29
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“Radiological scoring methods such as the Barr and Blethyn scores [2] and colon transit time (CTT) [3–5] which operate by means of X-rays and MRI, have generally been used for the assessment of bowel motility and, among these methods, the CTT described by Metcalf [3] is considered to”
Method
Colonic transit time in patient with slow-transit constipation: comparison of radiopaque markers and barium suspension method.
Xu, H.-M., Han, J. G., Na, Y., Zhao, B., Ma, H.-C., & Wang, Z.-J. (2011) · European Journal of Radiology · doi:10.1016/j.ejrad.2010.03.006 · Cited by 29
“In the radiopaquemarkersmethod,markerswere counted in the ight, left and rectosigmoid colon and total and segmental transit imes were calculated using the formula [2]: Total colonic transit time (h) =12/20×NI.”
Method
Traveler's Constipation
Kıykım, A., Altıntaş, E., Sezgin, O., Sezer, K., Tiftik, N., Akbay, E., Seyrek, E., & Konca, K. (2003) · American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2003.07249.x · Cited by 29
“colonic transit time (CTT) using radiopaque markers (5)”
Method
Long‐term results of colorectal resection for slow transit constipation
Hasegawa, Radley, Fatah, & Keighley (1999) · Colorectal Disease · doi:10.1046/j.1463-1318.1999.00025.x · Cited by 29
The effect of oral vancomycin on chronic idiopathic constipation
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Colonic motility in humans--a growing understanding.
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Recovery from disturbed colonic transit time after alcohol withdrawal
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Colonic Transit Disorders in Systemic Sclerosis
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Method
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Su, A., Gandhy, R., Barlow, C., & Triadafilopoulos, G. (2016) · BMJ Open Gastroenterology · doi:10.1136/bmjgast-2016-000118 · Cited by 28
“…constipation and overlap syndromes and may guide specific clinical management in patients with PD. assessment of colonic transit using Sitzmarks 2 and the assessment of anorectal pressures and sensation by ano-rectal manometry (ARM) and balloon expulsion test (BET) are important clinical tools…”
MethodInfluential
Non-invasive algorithm for bowel motility estimation using a back-propagation neural network model of bowel sounds
Kim, K.-S., Seo, J.-H., & Song, C.-G. (2011) · BioMedical Engineering OnLine · doi:10.1186/1475-925x-10-69 · Cited by 28
“Among these methods, the CTT described by Metcalf [2] is considered to be the gold-standard.”
MethodInfluential
Prediction of In Vivo Short-Chain Fatty Acid Production in Hindgut Fermenting Mammals: Problems and Pitfalls
Millet, S., Oeckel, M. J. V., Aluwé, M., Delezie, E., & Brabander, D. L. D. (2010) · Critical Reviews in Food Science and Nutrition · doi:10.1080/10408390802565939 · Cited by 25
“Hinton et al. (1969), Metcalf et al.(1987) and Lewis and Heaton (1997) worked with radio-opaque markers.”
Background
Validity of segmental transit studies used in routine clinical practice, to characterize defaecatory disorder in patients with functional constipation
Cowlam, S., Khan, U., Mackie, A., Varma, J., & Yiannankou, Y. (2008) · Colorectal Disease · doi:10.1111/j.1463-1318.2008.01566.x · Cited by 28
Colonic transit influences deoxycholic acid kinetics
Veysey, M. J., Thomas, L. A., Mallet, A. I., Jenkins, P. J., BESSER, G. M., Murphy, G. M., & Dowling, R. H. (2001) · Gastroenterology · doi:10.1053/gast.2001.28015 · Cited by 29
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Zhao, R.-H., Baig, K. M., Thaler, K., Mack, J., Abramson, S., Woodhouse, S., Tamir, H., Weiss, E., Nogueras, J., & Wexner, S. (2000) · American Journal of Gastroenterology · doi:10.1007/s10350-004-6500-x · Cited by 28
“This observation suggests a possible disruption of coordinated SR expression that may also contribute to the origin of CI.”
MethodInfluential
A biomagnetic method for studying gastro-intestinal activity
di Luzio, S., Comani, S., Romani, G., Basile, M., Gratta, C. D., & Pizzella, V. (1989) · Il Nuovo Cimento D · doi:10.1007/bf02459126 · Cited by 28
The effect of capsule size and density on transit through the proximal colon
Parker, G., Wilson, C., & Hardy, J. (1988) · The Journal of pharmacy and pharmacology · doi:10.1111/j.2042-7158.1988.tb05273.x · Cited by 28
Application of In Vitro Digestion Models in the Evaluation of Dietary Supplements
Ośko, J., Nasierowska, K., & Grembecka, M. (2024) · Foods · doi:10.3390/foods13132135 · Cited by 27
“Camilleri et al. [12] and Metcalf et al. [15] stipulate, however, that this value varies depending on the form of the meal, its abundance of protein and fat components, and the size of the portion consumed.”
Background
Slow gallbladder emptying reverts to normal but small intestinal transit of a physiological meal remains slow in celiac patients during gluten‐free diet
Benini, F., Mora, A., Turini, D., Bertolazzi, S., Lanzarotto, F., Ricci, C., Villanacci, V., Barbara, G., Stanghellini, V., & Lanzini, A. (2012) · Neurogastroenterology and Motility · doi:10.1111/j.1365-2982.2011.01822.x · Cited by 27
Normative Values for Colonic Transit Time and Patient Assessment of Constipation in Adults With Functional Constipation: Systematic Review With Meta-Analysis
Miller, L., Ibarra, A., & Ouwehand, A. (2017) · Clinical Medicine Insights: Gastroenterology · doi:10.1177/1179552217729343 · Cited by 26
The quest for biomarkers in IBS—where should it lead us?
Corsetti, M., Oudenhove, L. V., & Tack, J. (2014) · Neurogastroenterology and Motility · doi:10.1111/nmo.12475 · Cited by 26
A descriptive study of colorectal function in adults with Prader-Willi Syndrome: high prevalence of constipation
Kuhlmann, L., Joensson, I., Froekjaer, J. B., Krogh, K., & Farholt, S. (2014) · BMC Gastroenterology · doi:10.1186/1471-230x-14-63 · Cited by 26
“The segmental colonic transit time (SCTT) of the right (caecum, ascending and transverse colon) and the left colorectum (descending colon and rectosigmoid) were calculated as [20,21]:”
Method
Colonic Transit Study Technique and Interpretation: Can These Be Uniform Globally in Different Populations With Non-uniform Colon Transit Time?
Ghoshal, U., Sengar, V., & Srivastava, D. (2012) · Journal of Neurogastroenterology and Motility · doi:10.5056/jnm.2012.18.2.227 · Cited by 26
High-fiber rye bread improves bowel function in postmenopausal women but does not cause other putatively positive changes in the metabolic activity of intestinal microbiota
Gråsten, S., Juntunen, K. S., Mättö, J., Mykkanen, O., El-Nezami, H., Adlercreutz, H., Poutanen, K., & Mykkänen, H. (2007) · doi:10.1016/j.nutres.2007.05.010 · Cited by 26
“The difference in transit times is most apparent in the proximal colon [55].”
Background
Error count of radiopaque markers in colonic segmental transit time study.
Pomerri, F., Frigo, A., Grigoletto, F., Dodi, G., & Muzzio, P. (2007) · AJR. American journal of roentgenology · doi:10.2214/ajr.07.2278 · Cited by 26
“With the other technique, an identical number of markers are ingested on each of three consecutive days, and an abdominal radiograph is obtained on the fourth day [6].”
BackgroundMethod
Laparoscopic subtotal colectomy for colonic inertia
Sample, C., Gupta, R., Bamehriz, F., & Anvari, M. (2005) · Journal of Gastrointestinal Surgery · doi:10.1016/j.gassur.2005.01.294 · Cited by 26
Disturbances in large bowel motility
Spiller, R. E. (1999) · Best Practice & Research Clinical Gastroenterology · doi:10.1053/bega.1999.0035 · Cited by 24
C) Means to Enhance Penetration
Kompella, U., & Lee, V. H. (1992) · Advanced Drug Delivery Reviews · doi:10.1016/0169-409x(92)90017-k · Cited by 26
Abnormal Gastrointestinal Motility Is a Major Factor in Explaining Symptoms and a Potential Therapeutic Target in Patients with Disorders of Gut Brain Interaction
Camilleri, M. (2023) · Gut · doi:10.1136/gutjnl-2023-330542 · Cited by 25
Diagnostic Tests in Pediatric Constipation
Tambucci, R., Quitadamo, P., Thapar, N., Zenzeri, L., Caldaro, T., Staiano, A., Verrotti, A., & Borrelli, O. (2017) · Journal of Pediatric Gastroenterology and Nutrition - JPGN · doi:10.1097/mpg.0000000000001874 · Cited by 25
“Since CTT measured by ROM is comparable in children and young adults, it seems reasonable to use scintigraphic reference values derived from adults, although some normative data have been published in children (Supplemental Table 4, Supplemental Digital Content 5, http://links.lww.com/ MPG/B243) (25).”
BackgroundMethodInfluential
Randomized, double-blind, placebo-controlled trial of Ficus carica paste for the management of functional constipation.
Baek, H.-I., Ha, K.-C., Kim, H.-M., Choi, E.-K., Park, E.-O., Park, B.-H., Yang, H.-J., Kim, M. J., Kang, H., & Chae, S. (2016) · Asia Pacific Journal of Clinical Nutrition · doi:10.6133/apjcn.092015.06 · Cited by 25
Colectomy for refractory constipation
Raahave, D., Loud, F., Christensen, E. H., & Knudsen, L. L. (2010) · Scandinavian Journal of Gastroenterology · doi:10.3109/00365521003587796 · Cited by 25
“75 h in controls) was similar to that reported by other studies of healthy people [39,40].”
Result
Discrepancy between recalled and recorded bowel habits in irritable bowel syndrome
Coletta, M., Palma, L. D., Tomba, C., & Basilisco, G. (2010) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2010.04322.x · Cited by 26
“Colonic transit time Total colonic transit time was assessed according to Metcalf et al.(22) in the last 30 consecutive patients (19 women; mean age 33 8 years).”
Method
Diagnostic accuracy of the Barr and Blethyn radiological scoring systems for childhood constipation assessed using colonic transit time as the gold standard
Jackson, C., Lee, R., Wylie, A., Adams, C., & Jaffray, B. (2009) · Pediatric Radiology · doi:10.1007/s00247-009-1205-x · Cited by 25
“CTT using a recognized protocol [9], with appropriate values for children with and without constipation [10].”
Method
Audit of Constipation in a Gastroenterology Referral Center
Iantorno, G., Cinquetti, M., Mazzocchi, A., Morelli, A., & Bassotti, G. (2007) · Digestive Diseases and Sciences · doi:10.1007/s10620-006-9486-5 · Cited by 25
“This test was performed, according to a previously described method [13], by means of the ingestion of 20 radiopaque markers at the same time of day on three successive days, and then obtaining abdominal radiographs on Day 4 and/or Day 7.”
BackgroundMethod
Stooling patterns and colonic motility after transanal one-stage pull-through operation for Hirschsprung's disease in children.
Zhang, S.-C., Bai, Y.-Z., Wang, W., & Wang, W.-L. (2005) · Journal of Pediatric Surgery · doi:10.1016/j.jpedsurg.2005.07.027 · Cited by 25
Evaluation and management of pediatric refractory constipation: Recommendations from the NASPGHAN neurogastroenterology and motility committee.
Kilgore, A. L., Boruta, M. K. R., Ambartsumyan, L., Suarez, R. G., Patel, D., Wood, R. J., Darbari, A., & Rodriguez, L. (2024) · Journal of Pediatric Gastroenterology and Nutrition - JPGN · doi:10.1002/jpn3.12390 · Cited by 25
“(Agreement: 8/8).”
Evaluation of constipation in older adults: Radioopaque markers (ROMs) versus wireless motility capsule (WMC)
Rao, S. S. C., Coss‐Adame, E., Valestin, J., & Mysore, K. R. (2012) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2012.04.003 · Cited by 28
Breath Hydrogen Test After a Bean Meal Demonstrates Delayed Oro-Cecal Transit Time in Children with Chronic Constipation
Soares, A. C. F., Lederman, H., Fagundes-neto, U., & de Morais, M. D. (2005) · Journal of Pediatric Gastroenterology and Nutrition - JPGN · doi:10.1097/01.mpg.0000167499.40074.d7 · Cited by 24
“Total and segmental colonic transit time was measured using radiopaque markers (19).”
Method
Constipation Predominant Irritable Bowel Syndrome and Functional Constipation Are Not Discrete Disorders: A Machine Learning Approach
Ruffle, J. K., Tinkler, L., Emmett, C., Ford, A. C., Nachev, P., Aziz, Q., Farmer, A. D., & Yiannakou, Y. (2020) · The American Journal of Gastroenterology · doi:10.14309/ajg.0000000000000816 · Cited by 24
“All patients underwent a radio-opaque marker transit study, wherein transit time was determined according to a modified Metcalf protocol (22).”
Method
More Movement with Evaluating Colonic Transit in Humans
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Consenso mexicano sobre estreñimiento crónico
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Authors: Metcalf, A. M., Phillips, S. F., Zinsmeister, A. R., MacCarty, R. L., Beart, R. W., & Wolff, B. G.
Affiliations: Mayo Clinic (US)
Venue: Gastroenterology
Publisher: Elsevier BV
Published: 1987-01
Volume: 92
Issue: 1
Pages: 40-47
ISSN: 0016-5085 (ISSN-L)
DOI: 10.1016/0016-5085(87)90837-7
OpenAlex: W1567581279
Cited by: 928
References: 0
Citations by year: 2026: 10 · 2025: 10 · 2024: 14 · 2023: 23 · 2022: 16 · 2021: 24 · 2020: 28 · 2019: 33 · 2018: 23 · 2017: 29 · 2016: 38 · 2015: 28 · 2014: 15 · 2013: 30 · 2012: 30
FWCI: 14.56
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Gastroenterology (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (5r01am032121-03, 3p30am034988-01s1)
National Center for Research Resources (RR-585)
Topics: Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
Health Sciences › Medicine › Urology › Pelvic floor disorders treatments
Health Sciences › Medicine › Surgery › Intestinal Malrotation and Obstruction Disorders
Keywords: colonic transit, radiopaque markers, proximal colon, left colon, rectosigmoid, dietary fiber, radiation dose reduction
MeSH terms: Adult, Aged, Colon, Dietary Fiber, Digestive System, Female, Gastrointestinal Motility, Humans, Male, Middle Aged, Radiography

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Simplified assessment of segmental colonic transit

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