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Prognosis of constipation: clinical factors and colonic transit time

¹ Department of Paediatric Gastroenterology and Nutrition, Emma Children’s Hospital/Academic Medical Centre, Amsterdam, Netherlands
² Department of Clinical Epidemiology and Biostatistics, Academic Medical Centre, Amsterdam, Netherlands

Correspondence to:
Correspondence to:
Dr F de Lorijn
Department of Paediatric Gastroenterology and Nutrition, Emma Children’s Hospital/Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands; f.delorijn{at}amc.uva.nl

Background: Measurement of colonic transit time (CTT) is sometimes used in the evaluation of patients with chronic constipation.

Aim: To investigate the relation between symptoms and CTT, and to assess the importance of symptoms and CTT in predicting outcome.

Methods: Between 1995 and 2000, 169 consecutive patients (median age 8.4 years, 65% boys) fulfilling the criteria for constipation were enrolled. During the intervention and follow up period, all kept a diary to record symptoms. CTT was measured at entry to the study.

Results: At entry, defecation frequency was lower in girls than in boys, while the frequency of encopresis episodes was higher in boys. CTT values were significantly higher in those with a low defecation frequency (1/week) and a high frequency of encopresis (2/day). However, 50% had CTT values within the normal range. Successful outcome occurred more often in those with a rectal impaction. CTT results <100 hours were not predictive of outcome. However, those with CTT >100 hours were less likely to have had a successful outcome.

Conclusion: The presence of a rectal impaction at presentation is associated with a better outcome at one year. A CTT >100 hours is associated with a poor outcome at one year.

Abbreviations: CTT, colonic transit time; RSTT, rectosigmoid transit time; FNRFS, functional non-retentive faecal soiling

Keywords: constipation; colonic transit time; functional non-retentive faecal soiling

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