Application value and clinical characteristics of modified colonic transit test in classi-fication and diagnosis of chronic constipation
Objective To investigate the relationship between modified colonic transit test(CTT)classification and anorectal examination results and clinical characteristics in patients with chronic constipation.Methods A total of 189 patients with chronic constipation were enrolled and the scores of patient assessment of constipation quality of life(PAC-QoL),constipation scoring system scale(CSS),Bristol stool form scale(BSFS)were recorded.The patients were di-vided into four groups according to the results after 72 hours of modified CTT,including slow transit constipation(STC),mixed constipation(MC),defecatory disorder(DD)and normal transit constipation(NTC).Anorectal mano-metry(ARM)and defecography were also performed.The results of anorectal examination,demographic characteristics and related questionnaires were compared among the four groups.Results The 189 patients were classified as STC 67 patients(35.4% ),DD 19 patients(10.1% ),MC 39 patients(20.6% )and NTC 64 patients(33.9% ).BMI,stool frequency and constipation duration in CSS score,BSFS,anal resting pressure,rectoanal pressure gradient(RAPG),and the percentage of anal relaxation had statistical differences among the four groups(P<0.05).BMI in STC group was significantly higher than that in NTC group,the constipation duration score was significantly higher than that in DD group,and BSFS was significantly lower than that in NTC group(P<0.05).Anal resting pressure and the percentage of anal relaxation were significantly lower in DD group than those in STC,MC and NTC groups(P<0.05).RAPG was significantly lower in the STC group than that in the NTC group(P<0.05).Correlation analysis showed a negative cor-relation between BMI,stool frequency score and colonic 72 hours barium transmit site in constipated patients(r=-0.245,P=0.001;r=-0.185,P=0.011).RAPG and BSFS were positively correlated with colonic 72 hours barium transmit site(r=0.257,P=0.003;r=0.224,P=0.002).Conclusion The classification of modified CTT is related to the results of ARM and the clinical characteristics in chronic constipation patients,which has certain value in distin-guishing the subtypes of constipation and understanding the pathophysiology of constipation,and can preliminarily per-form constipation classification diagnosis and further guide treatment in medical centers without gastrointestinal motility testing.
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