Number of retained radiopaque markers on a colonic transit study does not correlate with symptom severity or quality of life in chronic constipation

Background Ingestion of radiopaque markers (ROM) is frequently used to determine colonic transit in chronic constipation. Although ≥20% of retained markers at 5 days defines slow‐transit constipation, some clinicians use the number of retained markers to determine disease severity. Methods We assemb...

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Bibliographic Details
Published in:Neurogastroenterology and motility 2018-05, Vol.30 (5), p.e13269-n/a
Main Authors: Staller, K., Barshop, K., Ananthakrishnan, A. N., Kuo, B.
Format: Article
Language:English
Subjects:
chronic constipation
Colon
Constipation
Correlation analysis
Intestine
Irritable bowel syndrome
Quality of life
severity
Sitz marker study
slow‐transit constipation
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Summary:Background Ingestion of radiopaque markers (ROM) is frequently used to determine colonic transit in chronic constipation. Although ≥20% of retained markers at 5 days defines slow‐transit constipation, some clinicians use the number of retained markers to determine disease severity. Methods We assembled a cross‐sectional cohort of patients presenting for evaluation of chronic constipation who underwent transit testing by ROM and completed validated symptom severity and quality‐of‐life (QOL) measures. We performed a correlation analysis to determine whether there was an association between number of retained markers and symptom severity and QOL. Key Results Among 159 patients undergoing evaluation for chronic constipation, there was poor correlation between the number of retained markers and symptom severity (R = .09, P = .25) and QOL. Among the 55 patients with slow‐transit constipation defined by ≥5 retained markers retained on day 5, there were similarly poor correlations between symptom severity (R = .17, P = .21) and QOL (R = .07, P = .60). Excluding patients with irritable bowel syndrome and outlet obstruction by balloon expulsion testing did not materially alter our results, nor did a multivariable analysis controlling for demographic and psychiatric confounders. Conclusions and Inferences Among patients with chronic constipation, number of retained markers on a ROM colonic transit study does not correlate with measures of symptom severity or QOL. Clinicians should be cautious about overinterpreting ROM transit testing. Retention ≥20% of retained markers at 5 days defines slow‐transit constipation in a radiopaque marker (ROM) study, but some clinicians use the number of retained markers as a surrogate for disease severity. We found no correlation between number of retained ROMs and symptom severity or quality of life in a cohort of patients presenting for evaluation of chronic constipation. The results of this study serve as a caution against the overinterpretation of ROM transit testing in chronic constipation.
ISSN:1350-1925
1365-2982
DOI:10.1111/nmo.13269