Colon Transit Time

What is a Colon Transit Time

When you eat a meal, the digestion and passage of food from the stomach through 12 to 15 feet of small intestine is done rapidly in just 6-8 hours; after which, the residue reaches the large intestine (also called colon). The transit in the colon slows drastically, and may normally take up to 16 hours to cross the 3-4 feet to the anus. In severe constipation, the Transit time through the small intestine remains 6-8 hours. But if the Transit time in the colon is prolonged, and stools may stay in the colon sometimes even for 5-7 days. This is called “Slow Transit Constipation”. But sometimes, the colon may bring the stools to the bottom “on time”; but you may not pass them out if the anal sphincters do not obey your command to relax. This is called “Dyssynergic defecation”. The Colon Transit Time test helps differentiate between the types of constipation, as well as the severity; thus will help choose a treatment for you.

The Transit Time Test helps us decide whether 

  • you really have Constipation at all; 
  • if the entire colon is slow, or;
  • if the pelvic floor is not relaxing to your commands.

How is a Colon Transit Time Test done?

Typically the test could take 5 days, 1-2 days to empty the colon, 1 ½  days to take the markers, and 2 days for the X-rays. Here I am describing a Time Table that is conveniently over a weekend; (minus 48 hours (Friday) to plus 60 hours – (Tuesday).

What exactly are the capsules for the Transit Time Test:

You have been given 12 capsules for the test. Each capsule contains 5 markers, thus we are using 60 markers for your test. The markers are made with a special Medical Grade resin, which is inert; that is, will not react with any body fluid. The chemical composition is such that it will not harm you. The marker will pass down the colon with the same speed of digested food. Its shape is such that it will not be missed or confused with anything on an x-ray examination.

What do Doctors look for in the X-rays:

We look to see how many markers are seen left behind on both these X-rays, to decide what type of constipation you have. We need to actually count all markers seen on each x-ray plate, and look for the distribution in the colon. There are many interpretations to this exercise, but to put it in a few words; if the markers are seen “all over” it could mean the whole colon is slow. If the markers are clustered in the pelvis, you may not be able to relax your anal muscles in a coordinated fashion to allow normal defecation.

Preparing for the test:

two days before the procedure:  cleaning the colon

Many severely constipated patients have become comfortable (as well as used to) a strong laxative by the time they come for the test. Some of these laxatives are habit forming (especially the ayurvedic / traditional medicine type; like choornas, etc). We do not recommend the use of these on a regular basis. However, this is the best way to get your colon clean. Thus, two nights before the procedure, I am recommending you to take the laxative that you are used to ONLY THIS ONE TIME, just to help us!

Take Peglec in 2 liters water in the morning, the day before the procedure. Look carefully at the color of the last stools you pass. If the color of the last stool after the Colon Wash has the same color as the water you drank; this means you have passed all stools through the wash and the colon is now empty. But in case you are still passing fecal masses following Peglec solution, you may need to repeat the bowel cleansing on the morning of the procedure. Please call me if you still see yellow feces in the fluid you pass out in the last stools on Friday.

Should I follow any diet through this time?

You are allowed to eat your normal diet throughout the 5 days of the procedure.

Day of starting the procedure, take the Transit Time Capsules: 

You will take 4 capsules washed down with 1-2 full glasses of water each time, on

  • Day of the procedure night (Hour zero, 4 capsules)
  • Next day morning 9 am (Hour zero +12, 4 capsules)
  • Next day evening 9 pm (Hour zero+ 24, 4 capsules.

You will NOT take ANY laxative after you have taken the first capsule till ALL X-ray examinations are over!!!! (for 5 days at least). 

The X-ray examination:

You will be doing the X-rays on a Digital X-ray machine at any X-ray Clinic of your convenience. Which Clinic you choose for the X-ray can be decided earlier with me. The test you will ask for at the X-ray Clinic is “Plain X-ray Abdomen with Pelvis Lying Down”.

  • Third day morning 9 am (Hour zero +36)
  • Fourth day morning 9 am (Hour zero + 60)

I would prefer sedation for the procedure!

Our Anaesthesia team will make sure you are comfortable throughout the procedure. It would be
preferable for them to review your records in advance, so they can plan appropriately for the day of the
procedure. The sedative will be injected through the cannula placed in the back of your hand, and you
should start to feel relaxed and drowsy almost immediately. Sedatives can sometimes affect your
breathing, so the amount of oxygen in your blood will be monitored constantly through a clasp on your
finger and you may be given extra oxygen through a mask.

After your procedure is complete you will be taken to the recovery area. The nurses there will continue
to monitor your blood pressure, pulse and oxygen saturation. Your “significant other” or friend may
come sit with you in recovery at this time. You may need to stay in the recovery area for even up to
three hours. Plan so you do not need to drive, operate machinery, sign any important documents or
make important decisions until the next day. You should not exercise strenuously until the next day.

You must make arrangements for a responsible adult to drive you home after your procedure. Taxis and
buses are not permitted unless you are accompanied by a responsible adult.