Prognosis of constipation: clinical factors and colonic transit time

BACKGROUND: Measurement of colonic transit time (CTT) is sometimes used in the evaluation of patients with chronic constipation.

AIM: To investigate the relation between symptoms and CTT, and to assess the importance of symptoms and CTT in predicting outcome.

METHODS: Between 1995 and 2000, 169 consecutive patients (median age 8.4 years, 65% boys) fulfilling the criteria for constipation were enrolled. During the intervention and follow up period, all kept a diary to record symptoms. CTT was measured at entry to the study.

RESULTS: At entry, defecation frequency was lower in girls than in boys, while the frequency of encopresis episodes was higher in boys. CTT values were significantly higher in those with a low defecation frequency (< or =1/week) and a high frequency of encopresis (> or =2/day). However, 50% had CTT values within the normal range. Successful outcome occurred more often in those with a rectal impaction. CTT results <100 hours were not predictive of outcome. However, those with CTT >100 hours were less likely to have had a successful outcome.

CONCLUSION: The presence of a rectal impaction at presentation is associated with a better outcome at one year. A CTT >100 hours is associated with a poor outcome at one year.