Segmental colonic transit time

Arhan, Pierre; Devroede, Ghislain; Jehannin, B; Lanza, Michel; Faverdin, C; Dornic, C; Persoz, B; Tétreault, L; Perey, Bernard; Pellerin, D

doi:10.1007/bf02605761

Cited by 443 publications

(312 citation statements)

References 17 publications

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“…Small intestinal transit time is more reproducible and has a range of about 3 -4 h [1,61]. Colonic transit time, on the other hand, is highly variable and is typically 10 -20 h [62][63][64].…”

Section: Physiological Parametersmentioning

confidence: 99%

Drug release from matrix tablets: physiological parameters and the effect of food

Nokhodchi

Asare-Addo

2014

Expert Opinion on Drug Delivery

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Introduction: As dissolution plays an important and vital role in the drug-delivery process of oral solid dosage forms, it is, therefore, essential to critically evaluate the parameters that can affect this process. Areas covered:The consumption of food as well as the physiological environment and properties of the gastrointestinal tract, such as its volume and composition of fluid, the fluid hydrodynamics, properties of the intestinal membrane, drug dose and solubility, pK a , diffusion coefficient, permeability and particle size, all affect drug dissolution and absorption rate. There are several dissolution approaches that have been developed to address the conditions as experienced in the in vivo environment, as the traditional dissolution being a quality control method is not biorelevant and as such do not always produce meaningful data. This review also describes the development of a systematic way that differentiates between robust and non-robust formulations by varying the effects of agitation and ionic strength through the use of the automated United States Pharmacopeia type III Bio-Dis apparatus. Expert opinion:With the improved understanding of the physiological parameters that can affect the oral bioperformance of dosage forms, strides have, therefore, been made in making dissolution testing methods more bio-logically based with the view of obtaining more in vitro--in vivo correlations.Keywords: agitation rate, biodissolution, drug release, effect of food, hydrophilic matrices, ionic strength Highlights -Understanding all the physiological parameters can serve as a basis for designing dissolution testing methods and systems that can more fully represent the gastrointestinal (GI) tract in humans and allow more in vitro-in vivo (IVIVC) correlations to be obtained thereby improving the oral bioperformance of dosage forms.-Simulation of GI conditions is essential to adequately predict the in vivo behaviour of drug formulations.-The choice of appropriate media for in vitro tests is crucial to their ability to correctly forecast the food effect in pharmacokinetic studies.-Several methods of dissolution testing have been conducted and are still ongoing that seek to further understand and develop media and dissolution methods to better represent the in vivo conditions and to aid in the better prediction of in vivo drug release.-Systematic change of agitation method and ionic strength evaluation may be used as additional tools in allowing for the identification of potential fed and fasted effects on drug release from hydrophilic matrices in the drive for developing dissolution methodologies that are more relevant in helping to achieve more IVIVC.

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Section: Physiological Parametersmentioning

confidence: 99%

Drug release from matrix tablets: physiological parameters and the effect of food

Nokhodchi

Asare-Addo

2014

Expert Opinion on Drug Delivery

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“…19 The patterns of colonic motility disorder were defined according to the following criteria [20][21][22] The upper limits of the normal range for right colon, left colon, and rectosigmoid total colonic transit time were, respectively, 62, 18, 20, and 34 hours. 19 …”

Section: Total and Segmental Colonic Transit Timesmentioning

confidence: 99%

Efeito do tratamento convencional da constipação crônica funcional no tempo de trânsito orocecal e colônico total e segmentar

Soares¹,

Tahan²,

Morais³

2009

J. Pediatr. (Rio J.)

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No conflicts of interest declared concerning the publication of this article. Methods: A total of 34 consecutive patients with functional constipation attending a specialized outpatient clinic were included in the study. Total and segmental colonic transit times were assessed using radiopaque markers. Hydrogen breath test was used to evaluate lactulose and bean orocecal transit times. Treatment consisted of disimpaction, general and dietary fiber intake instruction, and mineral oil administration.Results: At admission, colonic dysmotility was found in 71.9% (23/32) of patients. All patients who complied with the treatment showed improvement of clinical symptoms after 6 weeks of treatment, when 82.6% (19/23) of those with dysmotility at admission returned to normal or reduced the severity of colonic transit patterns. Transit time decreased (medians) between admission and eighth week of treatment: lactulose orocecal transit (from 70 to 50 minutes, p = 0.002), bean orocecal transit (from 240 to 220 minutes, p = 0.002), and total colonic transit (from 69.5 to 37.0 hours, p = 0.001). The need for mineral oil therapy for constipation after a 12-month treatment was associated with persistence of total colonic transit higher than 62 hours at the eighth week of treatment (p = 0.014). Conclusion:The conventional therapeutic approach yielded good results regardless of the presence or not of colonic dysmotility at inclusion in the study. Digestive tract motility abnormalities in functionally constipated children may be reversed, and may be secondary to constipation.

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“…Chronic functional constipation was defined according to Rome II Criteria (1) , for both primary FC and IBS with predominance of constipation ( Figure 1). on serology were referred to surgical treatment and excluded from the present study.…”

Section: Patientsmentioning

confidence: 99%

“…Retention of more than 20% of markers (four or more markers) along all colonic segments or into an isolated colonic segment was considered abnormal; (2) a modified METCALF et al technique (15) consisted in ingestion of 20 radiopaque markers on days 1, 2 and 3 of the study and abdominal x-rays taken on days 4 and 7. Transit in hours at the right, left, and rectosigmoid colon was calculated by adding all markers seen in these regions on days 4 and 7 multiplied by a constant according to the original study of ARHAN et al (1) . Total transit time of more than 68 hours, right colonic transit time of more than 32 hours, left colonic transit time of more than 39 hours and rectosigmoid transit time of more than 36 hours were considered to be abnormal (15) .…”

Section: Physiologic Testsmentioning

confidence: 99%

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Chronic constipation - the role of clinical assessment and colorectal physiologic tests to obtain an etiologic diagnosis

Lacerda‐Filho

Lima²,

Magalhães³

et al. 2008

Arq. Gastroenterol.

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-Background -Diagnosis of subtypes of chronic constipation has been considered difficult to achieve even in specialized centers.Although colorectal physiologic tests have brought an important contribution, it remains unclear in which patients these tests should be indicated for. Aims -This study aims to establish a differential diagnosis for chronic constipation cases using clinical assessment and physiologic tests and to identify clinical parameters that could predict which patients need physiologic tests. Methods -One hundred and seventy nine patients (83% females; mean age, 45) with chronic constipation according to Rome II criteria were initially treated by dietary advice and functional reeducation and those unresponsive (110 or 61.5%) were submitted to colonic transit time, defecography, anorectal manometry and electromyography, as needed. Results -A differential diagnosis was achieved in 63.6% of patients tested. However, 61.5% of 179 patients with chronic constipation (69 with no need to tests and 40 with normal tests) have etiologic diagnosis established only on clinical basis. Irritable bowel syndrome (32%), pelvic floor dysfunction (29%) and functional constipation due to faulty diet and life style habits (22%) were the main causes of chronic constipation. Alternating constipation and nausea/vomiting were symptoms significantly related to the diagnosis of irritable bowel syndrome; younger age, larger intervals between bowel movements, occurrence of fecal impaction and necessity of enema were related to the diagnosis of non-chagasic megacolon and digital assistance to evacuate and large rectocele or spastic pelvic floor on rectal exam were associated to pelvic floor dysfunction. Patients with long-standing constipation, fecal impaction, abdominal pain not eased after defecation, necessity for enemas, digital assistance and evidence of rectocele tended to be in need for physiologic tests to define the cause of chronic constipation. Conclusions -The etiologic diagnosis of chronic constipation can be achieved in most of patients on a clinical basis and some symptoms may be significantly related to specific diagnoses. Indications for physiologic tests should be based on specific clinical parameters.

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Segmental colonic transit time

Cited by 443 publications

References 17 publications

Drug release from matrix tablets: physiological parameters and the effect of food

Drug release from matrix tablets: physiological parameters and the effect of food

Efeito do tratamento convencional da constipação crônica funcional no tempo de trânsito orocecal e colônico total e segmentar

Chronic constipation - the role of clinical assessment and colorectal physiologic tests to obtain an etiologic diagnosis

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