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Radiology. 2003 Jul;228(1):279-83. Epub 2003 May 15.
Optimization of oral contrast agents for MR imaging of the small bowel.

Lauenstein TC, Schneemann H, Vogt FM, Herborn CU, Ruhm SG, Debatin JF.

Department of Diagnostic Radiology, University Hospital Essen, Hufelandstrasse 55, D-45122 Essen, Germany. thomas.lauensteini-essen.de

Effect on small-bowel distention of additives to water as contrast agents for magnetic resonance (MR) imaging was assessed. Oral contrast agents included water and water in combination with mannitol, a bulk fiber laxative, locust bean gum, and a combination of mannitol and locust bean gum. Filling of the small bowel was quantified on coronal images obtained with two-dimensional true fast imaging with steady-state precession sequence; bowel diameters were measured. Ingestion of water with locust bean gum and mannitol provided the best distention of the small bowel. MR imaging of the small bowel with oral administration of water can be improved with addition of osmotic and nonosmotic substances that lead to decreased water resorption.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12750457&dopt=Abstract

Rev Esp Enferm Dig. 2003 Mar;95(3):186-90, 181-5.
Measuring colonic transit time in chronic idiophatic constipation.

[Article in English, Spanish]

Husni-Hag-Ali R, Gomez Rodriguez BJ, Mendoza Olivares FJ, Garcia Montes JM, Sachez-Gey Venegas S, Herrerias Gutierrez JM.

Servicio de Aparato Digestivo. Hospital Universitario Virgen Macarena. Sevilla, Spain. jmhs.es

INTRODUCTION AND OBJECTIVES: Colonic transit time can define three types of delay: right colon (colonic inertial), left colon and recto sigmoid. The aim of this study is to compare clinic characteristics and manometric results among the different groups with segmental colonic transit disorder. PATIENTS AND METHODS: 61 subjects were included in our study (5 men and 56 women) with and average age of 47.5 years (range: 17-84 years). We carried our a study of segmental and total colonic transit time, with the use of radio-opaque markers and sequential abdominal X-rays. We considered that transit time was prolonged when it was longer than 72 hours, and segmental transit time, when right colon was longer than 22 hours, left colon 37.2 hours and recto-sigmoid 37.2 hours. We included different clinic data: age, sex, place of residence stool frequency, abdominal pain, painful evacuation, incomplete evacuation, evacuation desire, dietary fibre intake, use of laxatives. We practised anorectal manometry in 20 patients. RESULTS: The average total colonic transit time was 38.2 hours in normal transit and 103 hours with disorder. The frequency in the three colonic segments, when there was a long total colonic transit time, was: 40% in the left colon, 33% in the recto-sigmoid and 27% in the right colon. We analysed the clinical characteristics of these three groups, finding more frequency of painful evacuation and defecation desire and lower dietary fibre intake in recto sigmoid. The most important abnormality in anorectal manometry was the hiposensitivity in the anorectal area, that only appeared in subjects with long segmental transit time in the right colon (colonic inertia), statistically significant. CONCLUSIONS: The measurement of colonic transit time with radio-opaque markers is a simple technique that allows for the objective detection of the different groups of patients with chronic idiopathic constipation. The exact typification of the abnormality is important for the individualization of each treatment.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12760708&dopt=Abstract

Saudi Med J. 2003 May;24(5):S38.
Surgical management of chronic unremitting constipation and incontinence associated with massive elongation of left colon.

Mustafawi AR.

Department of Pediatric Surgery, Al-Wasl Maternity and Pediatric Hospital, Dubai, United Arab Emirates.

Aim of the study: Functional constipation rarely responds to medical management once huge delco sigma, the atomic baggy rectum or elongation of left colon has developed. We describe the treatment of 7 children with this difficult clinical problem by surgical management. Method: Seven children aged 3-11 years with a history of unremitting constipation and incontinence were referred for evaluation after failing medical management. All patients had normal lumbo sacrum, normal rectal biopsies, normal location of anus. However, 5 patients demonstrated a massive elongation of left colon and in 2 patients barium enema showed atomic baggy rectum. All of them had anal muscle stimulation, which was normal pre-operative. The elongated part of the left colon was resected as well as dilated rectum anastomosing the rest of the normal colon. Mean follow-up was 18 months. Results: Constipation and incontinence resolved within less than 2 months in 5 patients. The other 2 patients required some laxatives for 3-4 months after which they became normal. Barium enema obtained in 4 patients without evidence of recurrent elongation.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12778259&dopt=Abstract [PubMed - in process]

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