Bowel habits and gender correlate with colon length measured by CT colonography

Abstract

Purpose CT colonography enables three-dimensional measurement of colon length. However, previous studies using CT colonography have not examined the association with gender, age, physique, a history of laparotomy and bowel habits, all possible contributory factors to colon length. The aim of this study is to investigate factors associated with colon length. Materials and methods We conducted a post hoc analysis based on data obtained from a previous multi-center trial including 321 patients with positive fecal immunochemical tests who underwent CT colonography. Colon length was measured using a computer-generated center line and was divided at the iliac crest level into the distal and proximal colons. Bowel habits were classified into three groups: A—daily; B—once every 2 or 3 days; and C—less than once in 3 days. Statistical comparison was made using one-way ANOVA with Bonferroni’s correction. Results A total of 295 patients were analyzed. The entire colon length (cm, mean ± standard deviation) of individual patients was 150.3 ± 18.5 cm and ranged from 109.7 to 195.9 cm. The female colon was significantly longer than the male colon (154.3 ± 18.1 cm vs. 147.1 ± 18.3 cm; p = 0.022). Colon length showed trends associated with age (p = 0.18) and a history of laparotomy (p = 0.14). According to bowel habits, the entire colon measured 147.4 ± 17.9 in group A, 154.7 ± 18.5 in group B and 158.6 ± 18.3 in group C, and significant differences were observed for “A vs. C” (p = 0.002) and “A vs. B” (p = 0.014). In subgroup analysis by colon segment, the proximal colon trended similarly to the entire colon while there were no trends for the distal colon. Conclusions This study has clearly demonstrated that bowel habits and gender both correlate with the length of the entire colon measured by CT colonography, and in particular, the proximal colon. Secondary abstract Using CT colonography, we measured the colon length in 295 patients. The entire colon length was 150.3 ± 18.5 cm on average. Females and constipated (less frequent defecation) patients have a significantly longer colon, and in particular, the proximal colon. Colon length showed trends associated with age and a history of laparotomy.

Colon length in pediatric health and constipation measured using magnetic resonance imaging and three dimensional skeletonization

“…The colon in females was longer than in males in keeping with previous findings [ 19 ]. The reasons for this difference are unclear but could include hormonal and/or gynecological factors [ 19 ].…”

“…This illustrates that the organ volume changes shown in [ 12 ] are actually reflected in elongation which, in turn, may affect longitudinal muscle physiology. Colon elongation, affecting the longitudinal muscles, may be secondary as a result of fecal impaction [ 19 ], though it is difficult to dissect whether colonic elongation might be a primary factor in constipation [ 17 ]. The colon in females was longer than in males in keeping with previous findings [ 19 ].…”

“…Colon elongation, affecting the longitudinal muscles, may be secondary as a result of fecal impaction [ 19 ], though it is difficult to dissect whether colonic elongation might be a primary factor in constipation [ 17 ]. The colon in females was longer than in males in keeping with previous findings [ 19 ]. The reasons for this difference are unclear but could include hormonal and/or gynecological factors [ 19 ].…”

“Flexures and bends of the large intestine: Current terminology and a suggestion to simplify it”

“…Intestinal morphology is important for both endoscopic and radiological diagnostic procedures and conservative and surgical treatment (Bunni 2022; Kapadia 2017; Utano et al, 2021). There are at least three modern and very popular diagnostic tools – colonoscopy, capsule endoscopy and computed tomography colonography (so‐called virtual colonoscopy).…”

Acute colonic flexures: the basis for developing an artificial intelligence-based tool for predicting the course of colonoscopy

“…We supported the observations of other authors (Madiba et al 2008 ; Raahave 2018 ; Bourgouin et al 2012 ), which are important for different diseases or pathological bowel conditions. Utano et al (321 patients studied with CT colonography) analyzed colon length in relation to gender and bowel habits (constipation) and found that total colon length was greater in women with constipation (infrequent bowel movements) (Utano et al 2021 ). The same factors related to bowel anatomy are also important in diagnostic procedures, including colonoscopy or capsule endoscopy.…”