{"id":15054,"date":"2023-01-19T12:06:28","date_gmt":"2023-01-19T11:06:28","guid":{"rendered":"https:\/\/medifactia.com\/pl\/guidelines-standards\/"},"modified":"2023-12-04T10:07:49","modified_gmt":"2023-12-04T09:07:49","slug":"guidelines-standards","status":"publish","type":"page","link":"https:\/\/medifactia.com\/pl\/guidelines-standards\/","title":{"rendered":"Guidelines &#038; Standards"},"content":{"rendered":"<p><div  class='flex_column av-av_one_full-a961ec8c42a44a397321d1a2224da3ca av_one_full  avia-builder-el-0  el_before_av_hr  avia-builder-el-first  first flex_column_div  '     ><p>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_heading-d3df1d8f410a5baebccae33740efb6e6\">\n#top .av-special-heading.av-av_heading-d3df1d8f410a5baebccae33740efb6e6{\npadding-bottom:30px;\n}\nbody .av-special-heading.av-av_heading-d3df1d8f410a5baebccae33740efb6e6 .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-av_heading-d3df1d8f410a5baebccae33740efb6e6 .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-av_heading-d3df1d8f410a5baebccae33740efb6e6 av-special-heading-h1 blockquote modern-quote  avia-builder-el-1  el_before_av_table  avia-builder-el-first '><h1 class='av-special-heading-tag '  itemprop=\"headline\"  >Guidelines and Standard-of-Care<\/h1><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div><br \/>\n<div class='avia-data-table-wrap av-av_table-5badd1a78582b5d35616126e144c3606 avia_responsive_table avia-table-1'><table  id=\"guidelines\"  class='avia-table avia-data-table avia_pricing_default  avia-builder-el-2  el_after_av_heading  avia-builder-el-last '  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/Table\" ><tbody><tr class='avia-heading-row'><th class=''>Clinical Guidelines and Expert Opinions<\/th><th class=''>Year<\/th><\/tr><tr class=''><td class=''><em>\u2026\/\/\u2026 \u201cSegmental colon transit time is useful for differentiating slow-transit constipation from defecatory disorders in patients with chronic constipation\u201d\u2026\/\/\u2026 <sup>1<\/sup><em><\/td><td class=''>2023<\/td><\/tr><tr class=''><td class=''><em>\u2026\/\/\u2026 \u201dYour child needs a colonic transit study to show if there are any problems with their digestive system\u201d \u2026\/\/\u2026<sup>2<\/sup><br \/>\n\u2026\/\/\u2026\u201dThere are no risks to your child linked to taking the pellets needed for this test, and they will pass out of your child in their faeces. They can be flushed away safely\u201d\u2026\/\/\u2026<\/em><sup>2<\/sup><br \/>\n<\/td><td class=''>2023<\/td><\/tr><tr class=''><td class=''><em>\u2026\/\/\u2026 \u201dTransit time studies may be indicated in patients with rapid transit diarrhoea\u201d\u2026\/\/\u2026<\/em><sup>3<\/sup><\/td><td class=''>2022<\/td><\/tr><tr class=''><td class=''><em>\u2026\/\/\u2026 \u201cOur experience is that supplementary investigation of these patients with colon transit time, anorectal manometry, defecography with several examinations, may be of value to better characterize the underlying mechanisms of constipation and thereby improve the possibilities for targeted, albeit experimental treatment\u201d\u2026\/\/\u2026<\/em><sup>4<\/sup><\/td><td class=''>2021<\/td><\/tr><tr class=''><td class=''><em>\u2026\/\/\u2026 \u201cColonic transit studies this test is generally reserved for patients who have failed medical therapy, as it may guide further management including consideration of potential surgical interventions\u201d\u2026\/\/\u2026<br \/>\n\u2026\/\/\u2026 \u201cSlight 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\u201d\u2026\/\/\u2026<\/em><sup>5<\/sup><br \/>\n<\/td><td class=''>2020<\/td><\/tr><tr class=''><td class=''><em>\u2026\/\/\u2026 \u201cColonic transit tests are required to distinguish normal from slow-transit constipation, colonic scintigraphy and ROM can provide initial information to differentiate between diffuse and localized colonic dysmotility and\/or evacuation disorders and that the recommended diagnostic approaches are ROM studies and colonic scintigraphy, which are considered the best suited for measurement of CTT\u201d\u2026\/\/\u2026<\/em><sup>6<\/sup><br \/>\n<\/td><td class=''>2018<\/td><\/tr><tr class=''><td class=''><em>\u2026\/\/\u2026 \u201cWhen Treatment Isn&#8217;t Working. &#8222;Intractable&#8221; constipation means that the symptom does not respond to the treatments described above. Persons with intractable constipation may see a specialist for diagnostic tests. These may include: Transit time or colonic marker studies: A simple test that measures movement of material through the colon over time\u201d\u2026\/\/\u2026<\/em><sup>7<\/sup><\/td><td class=''>2017<\/td><\/tr><tr class=''><td class=''><em>\u2026\/\/\u2026 \u201cColonic transit is suggested if further investigation is needed after physiological testing\u201d\u2026\/\/\u2026 \u201cfurther diagnosis then depends on the presence or absence of colonic transit delay\u201d\u2026\/\/\u2026<sup>8<\/sup><\/em><\/td><td class=''>2017<\/td><\/tr><tr class=''><td class=''><em>\u2026\/\/\u2026 \u201c12. Statement: Colon transit time is useful for differentiating between the subtypes of defecatory disorders and slow transit constipation in patients with chronic constipation. Grade of recommendation: 1. Level of evidence: B. Experts\u2019 opinions: completely agree (20%), mostly agree (68%), partially agree (8%), mostly disagree (4%), completely disagree (0%), and not sure (0%)\u201d&#8230;\/\/\u2026<\/em><sup>9<\/sup><br \/>\n<\/td><td class=''>2016<\/td><\/tr><tr class=''><td class=''><em>\u2026\/\/\u2026 \u201c(9) Based on expert opinion, a colonic transit study may be useful to discriminate between functional constipation and functional nonretentive fecal incontinence and in situations in which the diagnosis is not clear\u201d\u2026\/\/\u2026<\/em><sup>10<\/sup><br \/>\n<\/td><td class=''>2014<\/td><\/tr><tr class=''><td class=''><em>&#8230;\/\/&#8230; \u201cinvestigations 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\u201d&#8230;\/\/&#8230;<\/em><sup>11<\/sup><\/td><td class=''>2013<\/td><\/tr><tr class=''><td class=''><em>\u2026\/\/\u2026 \u201cAssessments of colonic transit and anorectal function allow patients to be categorized into 3 subgroups (i.e., defecatory disorders, normal transit constipation [NTC], and slow transit constipation [STC]), which facilitates management in refractory patients\u201d&#8230;\/\/\u2026<\/em><sup>12<\/sup><br \/>\n<\/td><td class=''>2013<\/td><\/tr><tr class=''><td class=''><em>\u2026\/\/\u2026 \u201cCTT with ROM is proposed as one of the screening tests, indicated in patients with severe chronic constipation or alarm symptoms, to evaluate the category or type of constipation\u201d\u2026\/\/\u2026<\/em><sup>13<\/sup><\/td><td class=''>2010<\/td><\/tr><tr class=''><td class=''><em>\u2026\/\/\u2026 \u201cApplication: Measurement of total GITT and segmental colonic transit by repeated marker ingestion followed by a single X-ray is applicable both in clinical practice and in scientific studies of colonic transit\u201d\u2026\/\/\u2026<\/em><sup>14<\/sup><\/td><td class=''>1991<\/td><\/tr><\/tbody><\/table><\/div><style type='text\/css'>.avia-table-1 td:nth-of-type(1):before { content: 'Clinical Guidelines and Expert Opinions'; } .avia-table-1 td:nth-of-type(2):before { content: 'Year'; } <\/style><\/p><\/div><\/em><\/em><\/p>\n<div  class='hr av-av_hr-91d7ccd583a503147498e120fee2ff9b hr-default  avia-builder-el-3  el_after_av_one_full  el_before_av_one_full '><span class='hr-inner '><span class=\"hr-inner-style\"><\/span><\/span><\/div>\n<div  class='flex_column av-av_one_full-a8bf18c950d63b8f30b3da074addf237 av_one_full  avia-builder-el-4  el_after_av_hr  avia-builder-el-last  sources first flex_column_div  '     ><style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_textblock-3f01eeee24917c58a84244f9cae9dbb3\">\n#top .av_textblock_section.av-av_textblock-3f01eeee24917c58a84244f9cae9dbb3 .avia_textblock{\nfont-size:12px;\ncolor:#707070;\n}\n<\/style>\n<section  class='av_textblock_section av-av_textblock-3f01eeee24917c58a84244f9cae9dbb3 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock av_inherit_color'  itemprop=\"text\" ><ol>\n<li>Cho, Y.S., Lee, Y.J., Shin, J.E., et al (2023). 2022 Seoul Consensus on Clinical Practice Guidelines for Functional Constipation. J Neurogastroenterol Motil, Vol. 29, No. 3, 271-3015.<\/li>\n<li>The National Health Service (NHS), The Gastroenterology Investigation Suite in collaboration with the Child and Family Information Group (2020). Colon transit (pellet) study. https:\/\/www.gosh.nhs.uk\/conditions-and-treatments\/procedures-and-treatments\/colonic-transit-pellet-study\/. Accessed on November 22, 2023.<\/li>\n<li>Savarino, E., Zingone, F., Barberio, B., et al. (2022). Functional bowel disorders with diarrhoea: Clinical guidelines of the United European Gastroenterology and European Society for Neurogastroenterology and Motility. United European Gastroenterol J. Vol. 10, 556-584. https:\/\/doi.org\/10.1002\/ueg2.12259<\/li>\n<li>Grimheden, P., M\u00e5rtensson, T., Klevebro, S., et al (2021). Funktionell obstipation hos barn och ungdomar. https:\/\/gastro.barnlakarforeningen.se\/vardprogram-2\/. Accessed on November 22, 2023.<\/li>\n<li>Aziz, I., Whitehead, W.E., Palsson, O., T\u00f6rnblom, H. &amp; Simr\u00e9n, M. (2020). Expert Review of Gastroenterology &amp; Hepatology. An approach to the diagnosis and management of Rome IV functional disorders of chronic constipation [electronic version]. Taylor &amp; Francis Group, Vol. no. 14, 1-8.<\/li>\n<li>Keller, J., Bassotti, G., Clarke, J., et al. (2018). EXPERT CONSENCUS DOCUMENT. Advances in the diagnosis and classification of gastric and intestinal motility disorders [electronic version]. Nat Rev Gastroenterol Hepatol., Vol. 15(5), 291-308.<\/li>\n<li>The International Foundation for Gastrointestinal Disorders (IFFGD). Overview of Constipation Treatments. https:\/\/aboutconstipation.org\/treatment\/treatment-overview\/. Accessed on January 24, 2023.<\/li>\n<li>Rome IV. Diagnostic Algorithms for Common GI Symptoms. (2016). ROME IV DIAGNOSTIC ALGORITHM FOR COMMON GI SYMPTOMS. ROME FOUNDATION, RALEIGH, NORTH CAROLINA.<\/li>\n<li>Shin, J.E., Jung, H-K., Lee, T.H., et al. (2016). Guidelines for the Diagnosis and Treatment of Chronic Functional Constipation in Korea, 2015 Revised Edition. J Neurogastroenterol Motil., Vol. 22, 383-411.<\/li>\n<li>Tabbers, M.M., DiLorenzo, C., Berger, M.Y., et al. (2014). Evaluation and Treatment of Functional Constipation in Infants and Children: Evidence-Based Recommendations From ESPGHAN and NASPGHAN. JPGN. Vol. 58, No. 2, 258-274.<\/li>\n<li>Keshtgar, A.S., Ward, H.C., Clayed, G.S. (2013). Pathophysiology of chronic childhood constipation_ Functional and morphological evaluation by anorectal manometry and endosonography and colonic transit study. Journal of Pediatric Surgery. Vol. 48, 806-812.<\/li>\n<li>Bharucha, A.E., Dorn, S.D., Lembo, A., et al. American Gastroenterological Association [AGA]. (2013). GUIDELINE. Evaluation and management of constipation. https:\/\/gastro.org\/clinical-guidance\/evaluation-and-management-of-constipation\/. Accessed on November 22, 2023.<\/li>\n<li>Lindberg, G., Hamid, S., Malfertheiner, P., et al. (2010). World Gastroenterology Organisation Global Guidelines. Constipation: A Global Perspective. https:\/\/www.worldgastroenterology.org\/guidelines\/constipation\/constipation-english. Accessed on November 22, 2023.<\/li>\n<li>Scandinavian Association for Gastrointestinal Motility. (1991). Methods for studying gastrointestinal motility: consensus reports from working teams organized by Scandinavian Association for Gastrointestinal Motility (SAGIM). Almqvist &amp; Wiksell, Stockholm.<\/li>\n<\/ol>\n<\/div><\/section><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-15054","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/medifactia.com\/pl\/wp-json\/wp\/v2\/pages\/15054","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medifactia.com\/pl\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/medifactia.com\/pl\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/medifactia.com\/pl\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/medifactia.com\/pl\/wp-json\/wp\/v2\/comments?post=15054"}],"version-history":[{"count":3,"href":"https:\/\/medifactia.com\/pl\/wp-json\/wp\/v2\/pages\/15054\/revisions"}],"predecessor-version":[{"id":15086,"href":"https:\/\/medifactia.com\/pl\/wp-json\/wp\/v2\/pages\/15054\/revisions\/15086"}],"wp:attachment":[{"href":"https:\/\/medifactia.com\/pl\/wp-json\/wp\/v2\/media?parent=15054"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}