Intest Res.  2015 Oct;13(4):339-345. 10.5217/ir.2015.13.4.339.

Colon Transit Time May Predict Inadequate Bowel Preparation in Patients With Chronic Constipation

• Park HJ
• Chae MH
• Kim HS
• Kim JW
• Kim MY
• Baik SK
• Kwon SO
• Kim HM
• Lee KJ

• KMID: 2070750
• DOI: http://doi.org/10.5217/ir.2015.13.4.339

Abstract

BACKGROUND/AIMS
We evaluated whether colonic transit time (CTT) can predict the degree of bowel preparation in patients with chronic constipation undergoing scheduled colonoscopy in order to assist in the development of better bowel preparation strategies for these patients.
METHODS
We analyzed the records of 160 patients with chronic constipation from March 2007 to November 2012. We enrolled patients who had undergone a CTT test followed by colonoscopy. We defined patients with a CTT > or =30 hours as the slow transit time (STT) group, and patients with a CTT <30 hours as the normal transit time (NTT) group. Boston Bowel Preparation Scale (BBPS) scores were compared between the STT and NTT groups.
RESULTS
Of 160 patients with chronic constipation, 82 (51%) were included in the STT group and 78 (49%) were included in the NTT group. Patients with a BBPS score of <6 were more prevalent in the STT group than in the NTT group (31.7% vs. 10.3%, P=0.001). Multivariate analysis showed that slow CTT was an independent predictor of inadequate bowel preparation (odds ratio, 0.261; 95% confidence interval, 0.107-0.634; P=0.003). The best CTT cut-off value for predicting inadequate bowel preparation in patients with chronic constipation was 37 hours, as determined by receiver operator characteristic (ROC) curve analysis (area under the ROC curve: 0.676, specificity: 0.735, sensitivity: 0.643).
CONCLUSIONS
Patients with chronic constipation and a CTT >30 hours were at risk for inadequate bowel preparation. CTT measured prior to colonoscopy could be useful for developing individualized strategies for bowel preparation in patients with slow CTT, as these patients are likely to have inadequate bowel preparation.

Keyword

Colonoscopy; Bowel preparation; Colon transit time; Constipation

MeSH Terms

Colon*
Colonoscopy
Constipation*
Humans
Multivariate Analysis
ROC Curve
Sensitivity and Specificity

Figure

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  Fig. 1 Each segment of colonic transit time. Segments of colon were divided as right, left and rectosigmoid colon by black lines.

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  Fig. 2 Receiver operator characteristic graphs for the prediction of bowel preparation. A receiver operator characteristic (ROC) graph (A) showing the entire colon transit time (CTT), and a ROC graph (B) showing the left to right CTT for the prediction of inadequate bowel preparation. AUROC, Area under receiver operating characteristic.

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  Fig. 3 Based on the both cut-off values of 30 and 37 hours, proportions of inadequate bowel preparation were significantly higher in slow transit time (STT) than that in normal transit time (NTT). Cut-off values of colonic transit time (CTT) and inadequate bowel preparation.

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