Abstract
Background:
Total gastrointestinal transit times (GITT) and segmental colonic transit times (CTT) are commonly used to describe bowel function in individuals with spinal cord injury (SCI).
Study design:
Reproducibility study.
Objectives:
To describe inter- and intrasubjective as well as interobserver variations in GITT and segmental CTT in patients with SCI. Furthermore, to study associations between GITT or segmental CTT and colorectal symptoms.
Setting:
Spinal Cord Unit, Viborg Hospital, Denmark.
Methods:
Thirty SCI patients took 10 radio-opaque markers on 6 consecutive days and an abdominal X-ray was taken on day 7. The same procedure was repeated after 3 months. GITT and CTT were computed from the number of markers in the entire colorectum and in the left and the right colon. Intra- and interobserver variations were described as dispersion (numerical difference/mean).
Results:
Intersubjective variation was large for GITT (range: 0.6–6.3 days), right CTT (range: 0.1–5.5 days) and left CTT (range: 0–4.9 days). Intrasubjective variation was acceptable for GITT (dispersion: 0.28) but less good for right (dispersion: 0.63) and left CTT (dispersion: 0.68). Interobserver variation was very small. No correlations were found between GITT, right or left CTT and colorectal symptoms.
Conclusion:
GITT and right and left CTT are of limited value for clinical decision-making in individual patients but may be useful for comparison of groups of patients with SCI.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Glickman S, Kamm MA . Bowel dysfunction in spinal cord injury patients. Lancet 1996; 347: 1651–1653.
Krogh K, Nielsen J, Djurhuus JC, Mosdal C, Sabroe S, Laurberg S . Colorectal function in patients with spinal cord lesion. Dis Colon Rectum 1997; 40: 1233–1239.
De Looze D, Laere M, De Muynck M, Beke R, Elewant A . Constipation and other chronic gastrointestinal problems in spinal cord injury patients. Spinal Cord 1998; 36: 63–66.
Harari D, Sarkarati M, Gurwitz JH, McGlinchey G, Minaker KL . Constipation-related symptoms and bowel program concerning individuals with spinal cord injury. Spinal Cord 1997; 35: 394–401.
Finnerup NB, Faaborg PM, Krogh K, Jensen TS . Abdominal pain in long-term spinal cord injury. Spinal Cord 2007; 46: 198–203.
Faaborg PM, Christensen P, Finnerup N, Laurberg S, Krogh K . The pattern of colorectal dysfunction changes with time since spinal cord injury. Spinal Cord 2007; 46: 234–238.
Menardo G, Bausano G, Corazziari E, Fazio A, Marangi A, Genta V et al. Large-bowel transit in paraplegic patients. Dis Colon Rectum 1987; 30: 924–928.
Beuret-Blanquart F, Weber J, Gouverneur JP, Demangeon S, Denis P . Colon transit time and anorectal manometric anomalies in 19 patients with complete transaction of the spinal cord. J Auton Nerv Syst 1990; 25: 109–112.
Nino-Murcia M, Stone J, Chang P, Perkash I . Colonic transit in spinal cord-injured patients. Invest Radiol 1990; 25: 109–112.
Krogh K, Mosdal C, Lauberg S . Gastrointestinal and segmental colonic transit times in patients with acute and chronic spinal cord lesions. Spinal Cord 2000; 38: 615–621.
Wiesel PH, Norton C, Brazzelli M . Management of faecal incontinence and constipation in adults with central neurological diseases. Cochrane Database Syst Rev 2001; 4: CD002115.
Krogh K, Christensen P, Sabroe S, Laurberg S . The neurogenic bowel dysfunction score. Spinal Cord 2005; 44: 625–631.
Krogh K, Bach Jensen P, Gandrup P, Laurberg S, Nilsson J, Kerstens R et al. Efficacy and tolerability of Prucalopride in patients with constipation due to spinal cord injury. Scand J Gastroenterol 2002; 37: 431–436.
Binnie NR, Creasy GH, Edmond P, Smith AN . The action of Cisapride on the chronic constipation of paraplegia. Paraplegia 1988; 26: 151–158.
Geders JM, Gaing A, Bauman WA, Korsten MA . The effect of Cisapride on segmental colonic transit time in patients with spinal cord injury. Am J Gastroenterol 1995; 90: 285–289.
Leduc BE, Spacek E, Lepage Y . Colonic transit time after spinal cord injury: any clinical significance? J Spinal Cord Med 2002; 25: 161–166.
Maynard Jr FM, Bracken MB, Creasey G, Ditunno Jr JF, Donovan WH, Ducker TB et al. International standards for neurological and functional classification of spinal cord injury. American spinal cord injury association. Spinal Cord 1997; 35: 266–274.
Abrahamsson H, Antov S, Bosaeus I . Gastrointestinal and colonic segmental transit time evaluated by a single abdominal X-ray in healthy subjects and constipated patients. Scand J Gastroenterol 1988; 23 (Suppl 152): 72–80.
Agachan F, Chen T, Pfeiffer J, Reisman P, Wexner SD . A constipation scoring system to simplify evaluation and manangement of constipated patients. Dis Colon Rectum 1996; 39: 681–685.
Agachan F, Chen T, Pfeiffer J, Reisman P, Wexner SD . A constipation scoring system to simplify evaluation and management of constipated patients. Dis Colon Rectum 1996; 39: 681–685.
Vaizey CJ, Carapeti E, Cahill JA, Kamm MA . Prospective comparison of faecal incontinence grading systems. Gut 1999; 44: 77–80.
Christensen P, Bazzocchi G, Coggrave M, Abel R, Hultling C, Krogh K et al. A randomized, controlled trial of transanal irrigation versus conservative bowel management in spinal cord-injured patients. Gastroenterology 2006; 131: 738–747.
Krogh K, Olsen N, Christensen P, Madsen JL, Laurberg S . Colorectal transport during defecation in patients with lesions of the sacral spinal cord. Neurogastroenterol Motil 2003; 15: 25–31.
Christensen P, Olsen N, Krogh K, Bacher T, Laurberg S . Scintigraphic assessment of retrograde colonic washout in fecal incontinence and constipation. Dis Colon Rectum 2003; 46: 68–76.
Acknowledgements
This study was supported by grants from the Danish Association of Polio, Traffic and Accident Victims, The Ferdinand Salling Memorial Foundation and the Danish Research Council. The help from Susanne Døssing RN is much appreciated.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Media, S., Christensen, P., Lauge, I. et al. Reproducibility and validity of radiographically determined gastrointestinal and segmental colonic transit times in spinal cord-injured patients. Spinal Cord 47, 72–75 (2009). https://doi.org/10.1038/sc.2008.88
Received:
Revised:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/sc.2008.88
Keywords
This article is cited by
-
Colorectal transport during defecation in subjects with supraconal spinal cord injury
Spinal Cord (2013)
-
Do gastrointestinal transit times and colonic dimensions change with time since spinal cord injury?
Spinal Cord (2011)
-
Reliability of the International Spinal Cord Injury Bowel Function Basic and Extended Data Sets
Spinal Cord (2011)


