Reproducibility and validity of radiographically determined gastrointestinal and segmental colonic transit times in spinal cord-injured patients.

Background:Total gastrointestinal transit times (GITT) and segmental colonic transit times (CTT) are commonly used to describe bowel function in individuals with spinal cord injury (SCI).Study design:Reproducibility study.Objectives:To describe inter- and intrasubjective as well as interobserver variations in GITT and segmental CTT in patients with SCI. Furthermore, to study associations between GITT or segmental CTT and colorectal symptoms.Setting:Spinal Cord Unit, Viborg Hospital, Denmark.Methods:Thirty SCI patients took 10 radio-opaque markers on 6 consecutive days and an abdominal X-ray was taken on day 7. The same procedure was repeated after 3 months. GITT and CTT were computed from the number of markers in the entire colorectum and in the left and the right colon. Intra- and interobserver variations were described as dispersion (numerical difference/mean).Results:Intersubjective variation was large for GITT (range: 0.6–6.3 days), right CTT (range: 0.1–5.5 days) and left CTT (range: 0–4.9 days). Intrasubjective variation was acceptable for GITT (dispersion: 0.28) but less good for right (dispersion: 0.63) and left CTT (dispersion: 0.68). Interobserver variation was very small. No correlations were found between GITT, right or left CTT and colorectal symptoms.Conclusion:GITT and right and left CTT are of limited value for clinical decision-making in individual patients but may be useful for comparison of groups of patients with SCI.Spinal Cord (2009) 47, 72–75; doi:10.1038/sc.2008.88; published online 22 July 2008 [ABSTRACT FROM AUTHOR]