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BOWEL MOTILITY DISORDERS

Colon Transit Markers, Validated Method & Standardized Reporting Tool

Can Assist You in the Assessment and Treatment of Constipation, Diarrhoea and IBS

International experts (Mayo, Gothenburg and others) states that there are two transit methods able to differ between subtypes of functional disorders of the lower gastrointestinal tract and healthy individuals, the Mayo and the Transit-Pellets principle, the latter a study on 359 patients. The authors emphasize that both methods are validated and with respect to radiopaque markers a method with marker ingestion over six days should be preferred.
Keller et al., 2020
Slight differences in performing the test exist between laboratories, with one validated method being the ingestion of 10 radiopaque markers per day for six consecutive days, followed by fluoroscopy imaging on the morning of day 7 to count the remaining markers.
Aziz et al., 2020
The CTT of normal healthy children is not sex- or age-related (above the age of 3 years). The Abrahamson method for CTT measurement by using bony landmarks for the determination of colon segments is easy to perform and well tolerated with a virtual inexistent rating difference between different observers
Velde et al., 2013
Investigations of anorectal manometry, endosonography and colonic transit studies provide noninvasive objective assessment of diagnosis and severity of chronic IC and fecal incontinence in children. This information is valuable for the clinician to plan the treatment strategy and for parents and children to understand the underlying pathophysiology.
Keshtgar et al., 2013
CTT provides an objective measure to assess childhood constipation. To date, 6 studies using 5 different methods have been published reporting values for healthy children. Comparing these, Abrahamson’s method has low radiation exposure and is well tolerated. This study contributes additional normal values in children.
Wagener et al., 2004
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International experts (Mayo, Gothenburg and others) states that there are two transit methods able to differ between subtypes of functional disorders of the lower gastrointestinal tract and healthy individuals, the Mayo and the Transit-Pellets principle, the latter a study on 359 patients. The authors emphasize that both methods are validated and with respect to radiopaque markers a method with marker ingestion over six days should be preferred.

Keller et al., 2020

Slight differences in performing the test exist between laboratories, with one validated method being the ingestion of 10 radiopaque markers per day for six consecutive days, followed by fluoroscopy imaging on the morning of day 7 to count the remaining markers.

Aziz et al., 2020

The CTT of normal healthy children is not sex- or age-related (above the age of 3 years). The Abrahamson method for CTT measurement by using bony landmarks for the determination of colon segments is easy to perform and well tolerated with a virtual inexistent rating difference between different observers

Velde et al., 2013

Investigations of anorectal manometry, endosonography and colonic transit studies provide noninvasive objective assessment of diagnosis and severity of chronic IC and fecal incontinence in children. This information is valuable for the clinician to plan the treatment strategy and for parents and children to understand the underlying pathophysiology.

Keshtgar et al., 2013

CTT provides an objective measure to assess childhood constipation. To date, 6 studies using 5 different methods have been published reporting values for healthy children. Comparing these, Abrahamson’s method has low radiation exposure and is well tolerated. This study contributes additional normal values in children.

Wagener et al., 2004

Illustration of Transit-Pellets marker movement

A colon transit study with Transit-Pellets is frequently utilized in patients suffering from chronic constipation, chronic diarrhoea and/or irritable bowel syndrome (IBS). The purpose of this diagnostic test is to evaluate the transit time and how fast or slow food/stool travels through the intestines. The test involves the oral consumption of seven capsules over a six-day period, each containing tiny markers that can be visualized using X-ray imaging. Consuming the markers is safe and the markers will be eliminated in the feces and can be safely disposed of by flushing them down the toilet.

  • FDA 510(k) clearance for use in adult patients
  • FDA 510(k) clearance for use in pediatric patients (≥2 y/o)
  • CE marked (for use in adult patients)
  • Encapsulated colon transit markers
  • Capsules purely vegetarian
  • Easy to administer
  • Manufactured in Sweden
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Validated Method & Safe Colon Transit Markers for the Quantitative Evaluation of Overall & Regional Colonic Transit

The Transit-Pellets method and Transit-Pellets radiopaque markers can be used to:

  • Measure rapid, normal and slow colonic transit
  • Differentiate between slow transit and normal transit constipation
  • Identify segmental colon dysfunction in patients with constipation
  • Differentiate between normal and rapid transit diarrhoea
  • Identify treatment effects in patients with chronic constipation

A colonic transit test with the Transit-Pellets method, formerly known as the Abrahamsson method, and Transit-Pellets radiopaque markers can quantify the severity of transit problems. The test can be important in determining the need for additional diagnostic procedures, selecting the appropriate therapy, and predicting long-term prognosis. The test results can be used to guide decision-making in these areas.

References can be found in the VALIDATED METHOD section.

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Get Accurate Results with Transit-Pellets CTT Reporting System: The Online Standardized Colon Transit Test Report for Physicians and Radiologists

At Medifactia, we understand the importance of accurate and reliable test results in the medical field. That’s why we’ve created an online standardized colon transit test report specifically for treating physicians and radiologists. With this report, you’ll have access to precise and full colonic transit profile of each patient to help guide your diagnosis and treatment decisions.

With the patients X-ray plate in hand, count the remaining markers and enter the numbers as guided by CTT Reporting System. The system will then generate a comprehensive report, which includes:

  • An illustration of the colon with the respective marker count in each of the four colon segments
  • A table that displays information on the patient ́s total colonic transit time, benchmarked against established reference values
  • A graphical representation of the patient ́s segmental transit time, benchmarked against established reference values
  • Guidance on how to use the patient’s results to customize their treatment plan or advice on additional types of testing

This cutting-edge colon transit test report generated by CTT Reporting System is designed to engage and inform patients, presenting complex information in a way that is easy to understand and captivating.

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Diana Nyström
+46 (0) 8-460 072 06
diana.nystrom@medifactia.com

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The information on this website is for your general information only. Information you read on this website cannot replace the relationship that you have with your health care professional and is not intended to affect that relationship in any way. Medifactia does not practice medicine or provide medical services or advice, and the information on this website should not be considered medical advice. You should always talk to your health care professional for diagnosis and treatment. Health information changes quickly. Therefore, it is always best to confirm information with your health care professional.

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Colonic Transit Time (CTT) in Children and Adolescents: Reference Values

Colonic Transit Time (CTT) values are not normally distributed. Therefore, percentile 95 is often used for upper reference values.

Two studies on totally 76 healthy subjects, 3-18 years, have been performed with the Abrahamsson method (Transit-Pellets method) presenting percentile 95-values (Wagener et al 2004; Vande Velde et al 2013). In both studies the highest CTT value observed was 3.6 days (36 markers, 86.4 hours). In the Wagener study on 22 patient’s, percentile 95 was 3.5 days while in the Vande Velde study on 54 patients the percentile 95 was 3.3 days.

Rintala et al (1997) studied 25 healthy children with the same method. The highest CTT value observed was 3.4 days while percentile 95 was not reported.

For calculation of segmental transit times with the Transit-Pellets method four colonic sub-segments, cecum-ascending colon, transverse colon, descending colon and sigmoid colon-rectum, are usually considered, as done by Wagener et al.

Based on these reports a provisional upper reference value for CTT (percentile 95) of about 3.3 days (approximately 80 hours) in children and adolescents seems reasonable until further studies are conducted on larger groups.

 


Rintala, R.J., Marttinen, E., Virkola, K., et al (1997). Segmental Colonic Motility in Patients With Anorectal Malformations. Journal of Pediatric Surgery, Vol. 32, No. 3, 453-456.

Vande Velde, S., Notebaert, A., Meersschaut, V., et al (2013). Colon transit time in healthy children and adolescent. Int J Colorectal Dis., Vol. 28, 1721-1724.

Wagener, S., Shankar, R.R., Turnock, G.L., et al., (2004). Colonic Transit Time – What Is Normal? J Pediatr Surg., Vol. 39, 166-169.

Result in Hours

Colonic Transit Time (OATT); Reference Values 1, 2, 3

Normal transit time corresponds to the range from percentile 5 to percentile 95 in the control material. Reference values based on 199 subjects.

 

Segmental Transit Time; Upper Reference Values 1

Percentile 95 calculated per segment in healthy subjects.

 


1. Abrahamsson, H., Antov, S. & Bosaeus, I. (1988). Gastrointestinal and colonic segmental transit time evaluated by a single abdominal X-ray in healthy subjects and constipated patients. Scand J Gastroenterol. Vol. 23 (suppl 152), 72-80.

2. Sadik, R., Abrahamsson, H., Stotzer, P.O. (2003). Gender differences in gut transit shown with a newly developed radiological procedure. Scand. J. Gastroenterol., Vol. 38, 36-42.

3. Törnblom, H., et al. Data on File, Gastrointest Lab, Sahlgrenska University Hospital.

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