{"id":15213,"date":"2021-09-12T20:38:03","date_gmt":"2021-09-12T19:38:03","guid":{"rendered":"https:\/\/medifactia.com\/us\/?page_id=14674"},"modified":"2021-09-12T20:38:03","modified_gmt":"2021-09-12T19:38:03","slug":"clinical-advantage","status":"publish","type":"page","link":"https:\/\/medifactia.com\/sv\/clinical-advantage\/","title":{"rendered":"Clinical Advantage"},"content":{"rendered":"\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-1rag29e-04401544663aceeb6096b0a74fee8d15\">\n.flex_column.av-1rag29e-04401544663aceeb6096b0a74fee8d15{\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div  class='flex_column av-1rag29e-04401544663aceeb6096b0a74fee8d15 av_one_full  avia-builder-el-0  el_before_av_hr  avia-builder-el-first  first flex_column_div av-zero-column-padding  '     ><p>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-kthma91t-0c2e97ad41d13dd6bb41dbbdbde96737\">\n#top .av-special-heading.av-kthma91t-0c2e97ad41d13dd6bb41dbbdbde96737{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-kthma91t-0c2e97ad41d13dd6bb41dbbdbde96737 .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-kthma91t-0c2e97ad41d13dd6bb41dbbdbde96737 .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-kthma91t-0c2e97ad41d13dd6bb41dbbdbde96737 av-special-heading-h1 blockquote modern-quote  avia-builder-el-1  el_before_av_textblock  avia-builder-el-first '><h1 class='av-special-heading-tag '  itemprop=\"headline\"  >Chronic Constipation: Why Assess Colonic Transit Time (CTT) with the Transit-Pellet Single X-ray Method?<\/h1><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div><br \/>\n<section  class='av_textblock_section av-kthmav0w-6e87697d8619240c25a091f71536dfd3 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p>About 80% of the constipated patients undergoing CTT measurement are women, about 20% men. In general, most patients considered for CTT have already tried some therapies like food changes, bulking agents, or osmotic laxatives but with insufficient effect.<\/p>\n<p>Assessment of colonic transit is indicated to see if the patient has a transit abnormality or not. If abnormal, the test should disclose the type of transit disturbance.<\/p>\n<\/div><\/section><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-kthma91t-5-0be2c48456db2702493f4f3bc4ff70f7\">\n#top .av-special-heading.av-kthma91t-5-0be2c48456db2702493f4f3bc4ff70f7{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-kthma91t-5-0be2c48456db2702493f4f3bc4ff70f7 .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-kthma91t-5-0be2c48456db2702493f4f3bc4ff70f7 .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-kthma91t-5-0be2c48456db2702493f4f3bc4ff70f7 av-special-heading-h3 blockquote modern-quote  avia-builder-el-3  el_after_av_textblock  el_before_av_textblock '><h3 class='av-special-heading-tag '  itemprop=\"headline\"  >Points to be considered:<\/h3><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div><br \/>\n<section  class='av_textblock_section av-kthmav0w-4-d08c8d5d5add394ad3fb48825aed52f3 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><ol>\n<li>Select a single X-ray method that can distinguish between normal and delayed CTT in both men and women. This limit, defined as percentile 95 in healthy subjects, is around 2.5 days (55-60 hours) in men but around 3.9-4.0 days (approx. 95 hours) in women. The Transit-Pellet principle, introduced in 1986, with repeated, regular marker doses is the only single X-ray method to meet this requirement: Numerical CTT values are obtained over the full transit range from rapid to slow. In addition, the method yields segmental transit value, thus giving a complete colonic transit profile.<\/li>\n<li>After the CTT measurement, at follow up, discuss the results with the patient and show the transit profile diagram obtained. Discuss the transit profile in relation to the patient\u2019s symptoms.<\/li>\n<li>A normal transit value is seen in most patients with IBS and constipation, IBS-C,<sup>1<\/sup>\u00a0and is important to discuss with the patient. Show the normal CTT and the normal transit profile the patient has along the colon, despite his\/her feeling of severe constipation. This will help the patient understand that abnormal sensitivity is a cause and help eliminate the patient\u2019s fear of having a dangerous disease. This is a key point in patient education for IBS-C<sup>2<\/sup>\u00a0and helps reducing symptoms. Note that this assessment requires a method that can measure gender specific normal values. For example, a transit time in the order of 3.0 \u2013 3.6 days is a delay in male patients but completely normal for female patients.<\/li>\n<li>In patients having a delayed recto-sigmoid transit time, consider the possibility of an outlet obstruction disorder. For further exploration of such disorders special investigation may be needed such as balloon expulsion test, ano-rectal manometry, etc.<\/li>\n<li>A considerable part of the patients with constipation and slow transit have delay in left colon. If the patient has already tried the usual measures (see above), the transit value and transit profile obtained may motivate attempts with recently developed laxatives.<\/li>\n<li>Some patients with therapy refractory constipation have a delay also in the right colon with a caecum-ascendens transit time in the order of two days or more, thus, severe colonic inertia. In this group, usually refractory also to the newer laxatives, unconventional drugs may be tried before surgery is considered.<\/li>\n<li>Colonic surgery, e.g., colectomy with ileo-rectal anastomosis, to treat drug refractory constipation, is a rare operation today, but still performed in very selected cases by some specialized colorectal surgeons. In general, this procedure is only considered in patients with a long transit time also in the right colon (see point 6).<\/li>\n<\/ol>\n<\/div><\/section><br \/>\n<section  class='av_textblock_section av-lb3hwhz6-ccd45c98e0a56d6d581108d9ec8c4c12 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p><em>Hasse Abrahamsson MD; Emeritus Professor of Gastroenterology, 2022.<\/em><br \/>\n<em>Sahlgrenska Academy, University of Gothenburg.<\/em><\/p>\n<\/div><\/section><\/p><\/div><div  class='hr av-ow1or6-c747a12803e133104902f491f09753a6 hr-default  avia-builder-el-6  el_after_av_one_full  el_before_av_one_full '><span class='hr-inner '><span class=\"hr-inner-style\"><\/span><\/span><\/div><\/p>\n<div  class='flex_column av-m9sroy-72674f1df4216be724ee191eb94c2754 av_one_full  avia-builder-el-7  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-ldt9rqrt-5171d35032e3539e4a7decec00ac28c8\">\n#top .av_textblock_section.av-ldt9rqrt-5171d35032e3539e4a7decec00ac28c8 .avia_textblock{\nfont-size:12px;\ncolor:#707070;\n}\n<\/style>\n<section  class='av_textblock_section av-ldt9rqrt-5171d35032e3539e4a7decec00ac28c8 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock av_inherit_color'  itemprop=\"text\" ><ol>\n<li>T\u00f6rnblom H, et al. Colonic transit time and IBS symptoms: what\u2019s the link? Am J Gastroenterol. 2012;107:754-60<\/li>\n<li>Ringstr\u00f6m G, et al. Structured patient education is superior to written information in the management of patients with irritable bowel syndrome: a randomized controlled study. Eur J Gastroenterol Hepatol. 2010;22:420-8.<\/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":{"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"class_list":["post-15213","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/medifactia.com\/sv\/wp-json\/wp\/v2\/pages\/15213","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medifactia.com\/sv\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/medifactia.com\/sv\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/medifactia.com\/sv\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/medifactia.com\/sv\/wp-json\/wp\/v2\/comments?post=15213"}],"version-history":[{"count":0,"href":"https:\/\/medifactia.com\/sv\/wp-json\/wp\/v2\/pages\/15213\/revisions"}],"wp:attachment":[{"href":"https:\/\/medifactia.com\/sv\/wp-json\/wp\/v2\/media?parent=15213"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}