The current diagnosis of constipation is mostly based on the patient’s stool frequency and stool properties, etc., which do not reflect the specific site of the passage of prolongation, thus affecting the choice of treatment, and the determination of gastrointestinal transit time (GITT) can be accurately localized through the site of the prolongation and assess the severity of constipation and colonic incompetence, which is a great help in the selection of treatment, in order to observe the patients with constipation, a normal control group GITT characteristics comparison, and to improve the understanding of constipation and typing my department carried out the item research Baotou Poverty Alleviation Hospital Surgery Yu Yisheng 1. Objects Methods 1.1 Objects: 1.1.1 on the non-constipated people 25 – 70 years old average age of 47.5 years old, regardless of gender, ethnicity, occupation, randomly sampled 20 people who meet the following criteria “Abdominal pain, diarrhea, bloating, wasting, obesity. The number of bowel movements within the normal range, 3-4 times a week and, 2 times a day to do normal transmission time measurement group. 1.1.2 on constipation 25-70 years old, the average age of 47.5 years regardless of gender, ethnicity, occupation, 80 randomly selected. Meet the diagnostic criteria of Rome type III constipation A spontaneous emptying of feces “2 times or no bowel movement for a long time B at least once a week fecal incontinence C pain during defecation or a history of defecation difficulties D feces in the rectum, need to use the hand to assist defecation E feces is too small, too hard, too difficult to exclude To meet the above two or more, often for constipated patients with gastrointestinal transmission time measurement. 1.2 Materials; Oral markers (1 capsule containing 20 markers) 1.3 Methods; The study subjects were divided into a control group and a constipation group. Subjects since 3 days before the examination, prohibit laxatives and drugs affecting the function of the gastrointestinal tract and stimulating food, given according to certain standards of diet (containing about 14g of fiber per day) to maintain normal habits, no enema, no laxative, for those who failed to defecate for several days, it is estimated that it is difficult to continue to adhere to the completion of the examination, to be after the stools, and then prepared as required. After breakfast after the examination, swallow a capsule containing 20 impermeable x-ray markers, 4 hours after the fluoroscopic markers all into the mouth after the time, and then according to the control group, constipation group were 12h 24h 48h, 24h 48h 72h abdominal plain film, calculate the rate of discharge of markers and distribution. In the abdominal plain film from the thoracic vertebral spine to the fifth lumbar vertebral spine to make a line, and then from the fifth lumbar vertebral spine to the pelvic outlet on both sides of the tangent line, the colon is divided into three zones (rc) on the left side of the left hemi-colon area (lc) two tangent lines below the recto-sigmoid colon area (rs) markers shadow is easy to overlap the spinal column, the iliac fossa, it must be carefully searched for. Sometimes the colon, liver, spleen curvature position is higher, not all displayed on the x-ray, should be noted Calculation formula: TT (H) = TI + (T2-T1) (N-N1)/N2-N1 T1T2 refers to the number of hours on the abdominal plain film markers to the ingestion of the film, N1N2 refers to the time of the markers for the number of T1T2 passes through a certain point of the number of groups refers to the control group or constipated group, constipated group is expressed in 1, control group N1N2 refers to the number of markers passing through a certain point at time T1T2, respectively. The number of residual markers in each partition in each time period was calculated according to the above method. 2 Statistical methods Instead of using PEM3.1 software, the data obtained were analyzed, resulting in X ± s 3 Results Of the 100 cases examined, 80 cases of constipation and 20 cases of control patients, markers in the intestine through the various time comparisons of the control group and the constipation group, respectively, Table 1 Table 2: Table 1 Comparison of the transmission time of the control group and the constipation group Groups Specimen TGITT MITT RCTT LCTT RSTT Control group 20 34.8±16.1 5.9±0.7 20.1±6.2 22.6±13.4 31.9±13.4 Constipated group 80 62.6±14.1 6.2±0.7 33.4±14.1 42.6±16.9 61.4±17.8 NOTE: TGITT: Total GI Transmission Time MITT: Meconcentric Transmission Time RCTT With hemicolonic transit time LCTT: Left hemicolonic transit time RSTT: Rectosigmoid transit time. Table 2 Number of residual markers in the control and constipated groups at each time period of counting Groups 12 hrs 24 hrs 48 hrs 72 hrs Constipated group 19.2±3.2 14.3±6.8 9.3±8.4 Control 15.4±6.5 1.5±3.1 0.3±0.8 4 Discussion Constipation is a common disorder of defecation. It is not an independent disease, it is a complex symptom caused by a variety of diseases. At present, the diagnosis of constipation, mostly based on the patient’s stool frequency and stool properties, etc., which can not reflect, through the prolongation of the specific parts of the body, thus affecting the choice of treatment, affecting the health and quality of human beings, through the TGITT assay, no need for special equipment, safe, reliable, inexpensive, markers are small in size, non-absorbable, non-toxic, non-stimulating, does not affect the normal physiological function of the digestive tract. Markers in the digestive tract walking road by calculating the time of passage, accurately reflect the gastrointestinal tract transmission. Our hospital through 20 cases of normal group 80 cases of constipation group, TGITT method combined with the history of control part of the characteristic patients, do enema examination to analyze the results, so as to determine the cause of constipation, clinical diagnosis of TGITT method of typing accuracy. Therefore, the accuracy of TGITT method on the causes of constipation and clinical diagnosis and typing is determined. In addition, patients treated in another department must undergo two or three inspections to determine the presence or absence of colonic transmission dysfunction or the location of transmission dysfunction, whether the results of the two inspections are the same for those with transmission dysfunction, and whether there is total or partial colonic transmission dysfunction, to provide a basis for surgical treatment. Our hospital utilized the TGITT method, the constipation group and the control group was analyzed, showing that the constipation group of the colon segments and rectum through the time, compared with the control group of the time is significantly prolonged, from Table 1 shows that the constipation group in the TGITT compared with the control group of the delay of 27.8h, which is the most obvious is the RSTT constipation group compared with the control group of the delay of 29.5h, followed by the LCTT, RCTT, MITT, respectively Delay 20h, 13.3h, 0.3h. From the above, it can be seen that the constipation group time prolongation of the world is most obvious in the rectosigmoid colon, followed by the left half of the colon, the right half of the colon, and lastly, the mouth blind area. We through the markers I distribution in the digestive tract transmission process, a long time in an intestinal segment stagnation or distribution of a wide range of surfaces, as well as markers ultimately discharged rate, (the normal reference value is the marker after 72h at least exclude 80% of the markers or 16 particles) can be divided into 4 types of constipation: a slow transmission of the colon type: the markers are diffusely distributed with the whole colon, may be academician, vagus nerve disorders, slow intestinal peristalsis, intestinal Low tension, caused by irrational dietary structure Two exit obstructive: markers gathered in the rectosigmoid junction, the mother type is common, common causes for megacolon, hernia, decreased rectal sensory function, and pelvic floor loss of bradykinesia syndrome hernia Three left colon slow type: markers gathered in the left colon sigmoid colon to go, the possible causes of the left colon incompetence, congenital megacolon, occupancy, or secondary to with the exit of the obstruction. Four right colon slow type: markers gathered in the right colon, molding is rare, the possible causes are, intra-abdominal or abdominal ileocecal post-dominant lesions compression of the intestinal border caused by tumors, hydronephrosis, renal cysts Through the above study proved: the accuracy and simplicity of gastrointestinal transmission time measurement, is the first choice of the examination of the causes of constipation, combined with the relevant history, the examination can help to understand the typology of constipation, and to define the clinical diagnosis and treatment methods. References 1 Zhan Shuqin, Luo Jinyan Determination of gastrointestinal passage time in patients with constipation and its significance, Journal of Xi’an Medical University 1999.20 (3). 329.331 2 Ke Meiyun, Zhang Xiulan Determination of gastrointestinal passage time of impermeable x-ray markers and its clinical application, Journal of Surgical Colorectal and Anorectal Diseases 1997.3.(3).33 Author Yu Yisheng, Department of Gastrointestinal Surgery, Hospital for the Relief of Poverty in Baotou City, Inner Mongolia Tel. 0472-2802173 13171459677 E-mail: [email protected]