A RADIOPAQUE MARKER TECHNIQUE FOR MEASURING GASTROINTESTINAL TRANSIT IN SUBJECTS WITH AN ILEOSTOMY

We aimed to develop a simple, clinically useful technique for measurin g gut transit time in patients with an ileostomy, in order to distingu ish easily when patients have fast or slow transit. Seventeen healthy subjects (mean age, 55 years; range, 43-71 years; nine males) who had had a proctocolectomy for ulcerative colitis more than 1 year previous ly and without small intestinal resection were studied. Subjects were studied on 4 days after an overnight fast, two studies with and two wi thout breakfast. A standard diet was used on all days. Twenty radiopaq ue markers were given at the start of each study day. Ileostomy efflue nt was collected over 24 hr and x-rayed to determine the number of ret ained markers. Studies with breakfast demonstrated greater intrasubjec t reproducibility. The mean transit time for passage of 50% of markers was 16.6 hr with, and 14.8 hr without, breakfast (p < 0.02). From the data obtained we suggest that the optimum time for taking a single ab dominal radiograph in a patient with suspected fast transit is 6 hr af ter ingestion of markers, while the optimum time for a patient with su spected slow transit is 24 hr.