Transit-Pellets device are intended to be used to assess colonic transit time in adult patients with chronic constipation, chronic diarrhea or troublesome IBS. The markers represent the passage of solid and semi-solid contents. The markers are visible during X-ray due to the properties of Barium Sulphate, which is one of the ingredients in the device.
The most common reason to do this investigation is suspicion of so-called slow-transit constipation. However, with the new modification of marker intake on the sixth day, it is also possible to easily measure rapid passage, which could be of interest in the investigation of patients with chronic diarrhea.
Illustration (Source: Medifactia) of the movement of the medical device Transit-Pellets through the colon.
The device is prescribed by a physician for the patient to administer the device at home. The device is taken in a transparent HPMC capsule and passes through the mouth, throat and gastrointestinal tract. It is not surgically invasive.
On day seven, the patient undergoes an X-ray examination or fluoroscopy in a clinic.
Based on the number of retained markers and their position a colonic transit time is calculated and compared to reference values.
Times specified above are examples only.
The radiology examination should be scheduled 12 hours after the evening dose day six.
The composition of the Transit-Pellet markers has been selected to follow advice from international experts so that the markers reflect the transit of the solid and semisolid contents in the colon. Therefore, the proportion of the heavy barium sulphate was selected to be in the range 20-25% so that the specific gravity (SG) of the markers should be well below 2.0. Otherwise, the markers will not yield the actual colonic transit time. If the other standard component silicone or a similar is used in the manufacture process and the proportion of barium is increased to up to around 40% the SG of the particles of will be in the range 2.4 – 2.5! This is far above what is recommended by international experts (see articles by pioneers in the field, e.g. by Dr Cummings, Gut 1976;17:210-18). The radiological visibility will of course increase when using so much barium in the markers but the results obtained will not correctly measure the transit of colonic contents, that have a SG in the range 1.2 – 1.7. The dominating food residue cellulose has about 1.5.
