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Colonic Transit (colonic + transit)

Distribution by Scientific Domains

Medical Sciences	100%

Distribution within Medical Sciences

Gastroenterology & Hepatology	75%
Surgery & Surgical Specialties	16%

Terms modified by Colonic Transit

colonic transit time

Selected Abstracts

Increased colonic transit in rats produced by a combination of a cholinesterase inhibitor with a 5-HT4 receptor agonist

NEUROGASTROENTEROLOGY & MOTILITY, Issue 11 2009
K. Campbell-dittmeyer
Abstract, Increased cholinergic stimulation and accelerated gastrointestinal (GI) transit may be produced by direct stimulation of the acetylcholine (ACh) receptor with an appropriate agonist by increased release of ACh from cholinergic nerve terminals or by a decreased removal or breakdown of ACh within cholinergic synapses. The acetylcholinesterase inhibitor, neostigmine, and the 5-HT4 receptor partial agonist tegaserod, are two agents with known prokinetic activity which work by different mechanisms that result in increased levels of ACh at cholinergic synapses innervating intestinal smooth muscle. Here, we aimed to investigate the potential synergistic effect on colonic transit that may occur with concomitant use of these two agents. Colonic transit was indirectly assessed in rats via measurements of fecal pellet output every 30 min for 2.5 h following administration of neostigmine (0.003,0.1 mg kg,1, i.p.), tegaserod (0.01,1.0 mg kg,1, i.p.), or a combination of both compounds. When administered alone, neostigmine or tegaserod caused a dose-dependent increase in fecal pellet output. In combination, low doses of the two agents which did not produce statistically significant effects alone, compared to the vehicle, caused a significant increase in fecal pellet output. Combinations of higher doses of neostigmine and tegaserod did not display synergy. In summary, when combined at low doses, neostigmine and tegaserod produce synergistic effects manifested by a statistically significant increase in the expulsion of fecal pellets. A combination of an anticholinesterase agent with a 5-HT4 receptor agonist may prove to be a useful therapeutic approach to treat conditions associated with slow GI transit. [source]

Chronic constipation in children: Organic disorders are a major cause

JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 1-2 2005
BR Southwell
Abstract: Diagnostic tools for paediatric chronic constipation have been limited, leading to over 90% of patients with treatment-resistant constipation being diagnosed with chronic idiopathic constipation, with no discernible organic cause. Work in our institution suggests that a number of children with intractable symptoms actually have slow colonic transit leading to slow transit constipation. This paper reviews recent data suggesting that a significant number of the children with chronic treatment-resistant constipation may have organic causes (slow colonic transit and outlet obstruction) and suggests new approaches to the management of children with chronic treatment-resistant constipation. [source]

The effects of methylnaltrexone alone and in combination with acutely administered codeine on gastrointestinal and colonic transit in health

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 7 2010
B. S. Wong
Aliment Pharmacol Ther 2010; 32: 884,893 Summary Background, The short-term effects of methylnaltrexone (MNTX), a peripherally acting ,-opioid receptor antagonist, on gastrointestinal and colonic transit remain unclear. Aim, To compare the effects of placebo, codeine, subcutaneous (s.c.) MNTX and codeine with s.c. MNTX on gastrointestinal and colonic transit of solids in healthy humans. Methods, In a randomized, parallel-group, double-blind, placebo-controlled trial of 48 healthy volunteers, effects of 6 consecutive days of placebo [s.c. and p.o. (orally), n = 8], codeine (p.o. 30 mg q.d.s., n = 8), MNTX (s.c. 0.30 mg/kg, n = 16) and combined MNTX and codeine (same doses and routes, n = 16) on gastrointestinal and colonic transit were assessed. A validated scintigraphic method was used to measure transit during the last 48 h of treatment. Bowel function was estimated during treatment as well as 1 week preceding treatment using standard diaries. Analysis of covariance was used to assess treatment effects. Results, Codeine delayed colonic transit [geometric centre at 24 h (P = 0.04) and ascending colon t1/2 (P = 0.02)] and reduced stool frequency (P = 0.002), but had no effect on stool form. MNTX did not affect transit, stool frequency or stool form, either alone or with codeine (P > 0.3). No drug interaction effects were detected (P > 0.15). Conclusion, Methylnaltrexone does not alter gastrointestinal or colonic transit and does not reverse acute codeine-associated delayed gut transit in health. [source]

Effects of bisacodyl on ascending colon emptying and overall colonic transit in healthy volunteers

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 9 2009
N. MANABE
Summary Background, The mechanism of action of bisacodyl in the unprepared human colon remains unclear. Aim, To evaluate the effect of oral bisacodyl on the overall and regional colonic transit in humans. Methods, In a double-blind, randomized, placebo-controlled study of 25 healthy participants, effects of oral bisacodyl (5 mg p.o. per day) and placebo on colonic transit were compared. A validated scintigraphy method was used to measure colonic transit. The primary transit endpoints, ascending colon emptying t1/2 and geometric centre of colon isotope at 24 h (overall transit), were compared (Wilcoxon rank sum test). Results, There were significant treatment effects on ascending colon t1/2, with the bisacodyl group demonstrating accelerated emptying [median 6.5 h, interquartile range 5.0,8.0 h] relative to the placebo group [11.0 h (7.0,17.1); P = 0.03]. Numerical differences in colonic geometric centre 24 h [bisacodyl median 3.0 (2.2,3.8), placebo 4.0 (3.1,4.6)] were not significant (P = 0.19). There were no significant differences observed in geometric centre 4 h. Conclusion, Oral 5 mg bisacodyl accelerates ascending colon in the unprepared colon in healthy adults; this action may contribute to the drug's efficacy in constipation. [source]

Epidemiology of slow and fast colonic transit using a scale of stool form in a community

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 7 2007
R. S. CHOUNG
Summary Background, Measurement of gastrointestinal transit is commonly performed in the clinic, but data on transit in the community are lacking. Aim, To estimate the prevalence of slow and fast colonic transit using stool form, and potential risk factors. Methods, A validated self-reported gastrointestinal symptom questionnaire was mailed to 4196 randomly selected members of the community (response rate 54%). One question asked the subject to self-report their stool form using the Bristol Stool Scale. Results, Overall, 18%, 9% and 73% met stool form criteria for slow, fast or normal colonic transit, respectively. Increased odds for slow transit were observed with a higher Somatic Symptom Checklist score (OR = 1.6; 1.3,2.0), while a decreased odds for slow transit was observed in males relative to females (OR = 0.6; 0.5,0.8). An increased odds for fast transit was observed with higher Somatic Symptom Checklist score (OR = 2.3; 1.7,2.9) and a history of cholecystectomy (OR = 1.8; 1.2,2.8). Increasing body mass index (per 5 units) was associated with decreased odds for slow (OR = 0.85; 0.78,0.93), and an increased odds for fast (OR = 1.1; 1.04,1.24) colonic transit. Conclusion, Based on stool form assessment, nearly one in five community members may have slow colonic transit and one in 12 have accelerated colonic transit. [source]

Actions of prolonged ghrelin infusion on gastrointestinal transit and glucose homeostasis in humans

NEUROGASTROENTEROLOGY & MOTILITY, Issue 6 2010
Y. Falkén
Abstract Background, Ghrelin is produced by enteroendocrine cells in the gastric mucosa and stimulates gastric emptying in healthy volunteers and patients with gastroparesis in short-term studies. The aim of this study was to evaluate effects of intravenous ghrelin on gastrointestinal motility and glucose homeostasis during a 6-h infusion in humans. Methods, Ghrelin (15 pmol kg,1 min,1) or saline was infused intravenously for 360 min after intake of radio-opaque markers, acetaminophen, and lactulose after a standardized breakfast in 12 male volunteers. Gastric emptying, orocecal transit, colonic transit, postprandial plasma concentrations of glucose, insulin, glucagon-like peptide-1 (GLP-1), and peptide YY were assessed. In vitro studies of gastrointestinal muscle contractility were performed. Key Results, The gastric emptying rate was faster for ghrelin compared to saline (P = 0.002) with a shorter half-emptying time (50.3 ± 3.9 vs 59.9 ± 4.4 min, P = 0.004). There was no effect of ghrelin on orocecal or colonic transit. Postprandial elevations of plasma glucose, insulin, and GLP-1 occurred 15 min earlier and were higher with ghrelin. The insulinogenic index did not change during ghrelin infusion. Basal in vitro contractility was unaffected by ghrelin. Conclusions & Inferences, The effect of a 6-h ghrelin infusion on gastrointestinal motility is limited to the stomach without affecting orocecal or colonic transit. Plasma glucose, insulin, and GLP-1 are elevated postprandially, probably as a result of the hastened gastric emptying. Changes in glucose homeostasis as a consequence of stimulated gastric emptying and hormone release, need to be taken into account in the use of pharmacological stimulants for the treatment of motility disorders. [source]

Increased colonic transit in rats produced by a combination of a cholinesterase inhibitor with a 5-HT4 receptor agonist

Enteric neurodegeneration in ageing

NEUROGASTROENTEROLOGY & MOTILITY, Issue 4 2008
M. Camilleri
Abstract, The objective of this article is to review the clinical presentation and neurobiology of degeneration of the enteric nervous system with emphasis on human data where available. Constipation, incontinence and evacuation disorders are frequently encountered in the ageing population. Healthy lower gastrointestinal function is essential for successful ageing as it is critical to maintaining independence and autonomy to pursue further activity. One clinical expression of enteric neurodegeneration is constipation. However, the aetiology may be multifactorial as disturbances of epithelial, muscle or neural function may all result from neurodegeneration. There is evidence of loss of excitatory (e.g. cholinergic) enteric neurons and interstitial cells of Cajal, whereas inhibitory (including nitrergic) neurons appear unaffected. Understanding neurodegeneration in the enteric nervous system is key to developing treatments to reverse it. Neurotrophins have been shown to accelerate colonic transit and relieve constipation in the medium term; they are also implicated in maintenance programmes in adult enteric neurons through a role in antioxidant defence. However, their effects in ageing colon require further study. There is evidence that 5-HT2 and 5-HT4 mechanisms are involved in development, maintenance and survival of enteric neurons. Further research is needed to understand and potentially reverse enteric neurodegeneration. [source]

Alvimopan, a selective peripherally acting , -opioid antagonist,

NEUROGASTROENTEROLOGY & MOTILITY, Issue 2 2005
M. Camilleri
Abstract, Alvimopan is a novel, peripherally acting , -opioid antagonist that is being developed for the management of acute postoperative ileus and for the reversal of the delayed gastrointestinal and colonic transit that result in symptoms such as constipation, nausea and motility disorders in patients treated with opiate analgesics. There is a clinical need for effective medications for the treatment of postoperative ileus and opiate-induced constipation and other motility disorders. This review addresses the basic and applied pharmacology and current evidence for the use of the medication, alvimopan, in clinical gastroenterology. [source]

Strategy for the surgical management of patients with idiopathic megarectum and megacolon,

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 10 2001
C. B. Ó Súilleabháin
Background: Several surgical procedures have been used to treat idiopathic megabowel. A structured approach to the surgical management of megarectum/colon is reported. Methods: Twenty-eight consecutive patients with megabowel referred for surgery were reviewed. All patients had conservative treatment for 6 months. Those failing to improve underwent full-thickness biopsy of the anorectal junction, anorectal physiology studies, colonic transit studies and evacuation proctography. Surgery involved excision of the abnormal large bowel and formation of an anastomosis (coloanal or ileoanal) using ,normal' bowel identified either by a defunctioning stoma or colonic motility studies. Results: Eight patients responded to conservative management. Two patients were lost to follow-up and one died from unrelated causes. Two of the 17 patients who underwent full-thickness biopsy were cured by the procedure. Anorectal physiology, colonic transit and evacuation studies did not aid selection of the surgical procedure performed in 15 patients: proctectomy and coloanal anastomosis (six), restorative proctocolectomy (three), panproctocolectomy (one) and defunctioning stoma (five). At a median follow-up of 3·6 years, 13 of 15 evaluable patients had a satisfactory outcome. Conclusion: Approximately 40 per cent of patients with megabowel referred for surgery responded to conservative treatment. The remaining patients may be treated successfully by surgery. The use of either a ,diagnostic' defunctioning stoma or colonic motility studies may aid in the choice of surgical procedure. © 2001 British Journal of Surgery Society Ltd [source]

Segmental colonic transit studies: comparison of a radiological and a scintigraphic method

COLORECTAL DISEASE, Issue 4 2007
E. Lundin
Abstract Objective, Colonic transit studies are used to diagnose slow transit constipation (STC) and to evaluate segmental colonic transit before segmental or subtotal colectomy. The aim of the study was to compare a single X-ray radio-opaque marker method with a scintigraphic technique to assess total and segmental colonic transit in patients with STC. Method, Thirty-one female patients (median age 46 years) with severe constipation and a prolonged or borderline prolonged colonic transit time on radio-opaque marker study were included in the study. They were subsequently investigated with 111Indium-DTPA colonic transit scintigraphy, with a median time between the investigations of 4(range 1,27) months. Normal values of healthy female controls were used for comparison. Results, There was no difference between the two methods in terms of prolonged or normal total colonic transit time. Twenty-nine of 31 female patients had a prolonged transit time only in one or two segments on the marker study. On scintigraphy, the transit time was prolonged for patients in the left (P < 0.05 to P < 0.001), but not in the right colon. With respect to prolonged or normal segmental transit time, there was a significant difference between the two methods only in the descending colon (P = 0.02). However, the results varied considerably for individual patients. Conclusion, Segmental colonic delay was a common finding. The two methods gave similar results for groups of patients, except in the descending colon. The variation of the results for individuals suggests that a repeated transit test may improve the assessment of total and segmental transit. [source]