Scintigraphic assessment of colonic transit in women with slow-transit constipation arising de novo and following pelvic surgery or childbirth

Background: Colonic transit has not been compared between patients with slo w-transit constipation (STC) arising ne novo (idiopathic) and those whose s ymptoms followed pelvic surgery or childbirth (acquired). Methods: In 48 women, with either idiopathic (n = 36) or acquired (n = 12) STC, In-111-radiolabelled diethylene-triamine penta-acetic acid colonic sci ntigraphy was performed to determine patterns of delay (generalized or left sided), the 'severity' of transit disturbance between subgroups, and the a ssociation with age or duration of symptoms. Results were compared with tho se in healthy women. Patterns of colonic transit disturbance were assessed using previously defined criteria. In those with a generalized delay, varia bles reflecting the overall rate of isotope progression throughout the colo n were calculated: gradient of geometric centre of isotope progression and estimated evacuation time of the isotope. Results: The pattern of transit delay was similar between the subgroups, bu t the 'severity' of the transit abnormality was significantly worse in thos e with chronic idiopathic symptoms. Tn the chronic idiopathic STC subgroup only, there was a significant correlation between both age and duration of symptoms and severity of transit disturbance. Conclusion: This study demonstrates that differences in colonic transit exi st between subgroups of patients with STC. These might be explained by diff erences in duration of symptoms or differences in aetiology.