# your sitz marker test results?



## 20240 (Jul 28, 2006)

How many of you have chronic, unrelieved c. but have had the sitz marker test come out negative (i.e. passed all the markers in the "normal" amount of time?) I took my test last week and am still amazed at the result.Would love to hear your comments.


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## SpAsMaN* (May 11, 2002)

It's so sad that many doctors don't know or don't use this test.The best test is to take 3 radiography during Sitz marker ingestion.That is explained on the web site in my signature.


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## 20240 (Jul 28, 2006)

SpAsMaN-I injested the "pill" at 5:00 on Sunday and then had a KUB done on Mon., Wed., and Fri.All but 5 markers were gone by Wed.







All were clear by Friday.







I still can't understand this and would like to know if anyone else has had the same result. I have had chronic c. for as long as I can remember. One of my earliest memories is as a child, sitting on the can staring at the goldfish on the bathroom walpaper waiting for you-know-what(which never showed up), listening to the kids playing outside wishing I could be doing the same. NOT FAIR THEN, NOT FAIR NOW


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## Kathleen M. (Nov 16, 1999)

You can be chronically constipated and have normal/near normal transit times.Oftentimes constipation is more due to issues with stool consistancy or ability to relax the sphincters to let it out than you have screwed up motility. Basically you can get it to the end, but for whatever reason you can't get it out well.Constipation with normal transit times is treated differently than constipation with abnormal transit times so knowing which version you have can be helpful in the long run.K.


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## 20240 (Jul 28, 2006)

Kathleen,I had the anal manometry done a couple of weeks ago. Perfect scores (go me!) so I know that is not the problem. Unfortunately, when I took the test, my current "laxative cocktail" was still working even though I had stopped taking it on the Friday before. Go figure. That is why I was asking for other people's results.


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## Kathleen M. (Nov 16, 1999)

In theory if you sitz markered all IBS-C types almost all of them would have normal-near normal transit times.A small percentage of constipated people have motility issues, but they tend to be the more severe end of the spectrum. Without laxative they may go more than a week between BM's and typically these people eventually need to be on a very low residue (fiber) diet as having 2-3 weeks of fiber in your colon is very uncomfortable and may eventually need a sub-total colectomy (colon removal).This usually isn't where IBS-C types end up. The colon can still move things along it is finding out how to get the consistancy such that they keep moving it along. Motility issues mean that even with good consistancy nothing moves very well.K.


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## Sean (Feb 8, 1999)

As I understand it, the Sitzmarker test is diagnostic for colonic inertia, which is just one form of constipation. A person could have a normal Sitzmark test and still have another form of constipation.All 24 markers were still in me after five days, so I got a definitive diagnosis of colonic inertia. I could have skipped the x-ray, however, as I knew that all of the markers were still in my colon. I had not had a bowel movement between the time I swallowed the capsule and the time of the x-ray. Considering that I couldn't take anything to move my bowels for a few days prior to taking the capsule, I was pretty miserable and impacted by the day on which I went for the x-ray of my colon. It is ironic that I finally got a diagnosis with a remarkably simple and non-invasive test after years of undergoing all of the usual invasive and uncomfortable tests like barium enemas, colonoscopies, flex sigs, rectal mannometry, etc. Ugh.


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## 16522 (Apr 6, 2005)

Sean,How did your markers end up? Scattered throughtout colon or on one side? Mine were all on the left side. I was wearing a Duragesic patch for pain at time. I asked about that and they said it was okay, but then found out afterwards that it wasn't as it can cause constipation. The surgeons say I have colonic onertia and the gastroenterologist say that my colon is moving if they are all on the left side. Maybe I just have a less severe case. I do think I have a motility issue though. The surgeons say I am not a good candidate for the surgery as I have a lot of pain and the surgery doesn't always help with pain. How are you treating your condition? The only thing that helps me at all is a herbal laxative which probably isn't so good as the herbs are stimulating and I've been trying accupuncture. I think it helps a little but no miracle. Zelnorm helps in the beginning, but then fizzles out. Too bad and Amitiza didn't do anything but give me a lot of side effects. thanks for your reply.


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## Sean (Feb 8, 1999)

Roberta,My markers were pretty evenly distributed throughout the transverse and descending colon. There were a few in the sigmoid colon. I don't remember any in the ascending colon. The Sitzmark test was 7 years ago, so I don't remember all of the details. I do know that I was badly impacted by the time it was over - a fact that the radiologist noted. I am treating my condition with a combination of miralax and zelnorm. I have to continually change the combination of things I use because my colon seems to build up a tolerance to the meds over time and gradually shuts down. I do take "holidays" from the Zelnorm periodically. Whenever the drugs fail to work, I have to resort to a bag-type warm water enema. I never let myself go more than three days without a bm. For me, that is just asking for trouble. Herbal laxatives (I assume the kind with the stimulant senna) also work for me if I take them in larger than recommended doses. They cause me a lot of discomfort and are not recommended for long term use, so I try not to resort to them very often.


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## kowgirl (Nov 2, 2011)

need some help


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## kowgirl (Nov 2, 2011)

I'm sorry ya'll are having trouble, but I'm so glad I'm not alone! I have been having severe constipation for awhile. I saw a colon/rectal specialist who did a colonoscopy, which turned up nothing. They only thing they did was put me on a bunch of meds. Now I am seeing a GI doc who just did the Sitz Marker Test. I am waiting for a diagnosis, but I already know there was a bunch of those markers left inside. It's hard to go anywhere when you're feeling bloated and miserable. I am currently taking Neurontin, Amitiza, 3 cap fulls of Miralax (triple the normal dose), and the doc also has me drinking "Dieter's Tea" (that herbal stimulant you guys were talking about). I should be poopin' from here to Hawaii by now, but it's just not doing anything. When I was desperate, I used an enema, but even that doesn't work anymore. I have tried an OTC Suppository that a friend told me about and that gives me a little relief. I don't want to go too far from home in the fear that all these meds MIGHT just kick in at an inopportune time! Since many of you have had the Sitz Marker Test, what happened next? Sorry if it's all TMI, but it was so good to see I have people who can understand going through this!! Thanks.


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## annie7 (Aug 16, 2002)

oh no, you're not alone and yes chronic c sure is a challenge to live with--i've had c problems for over forty years.i just finished the sitz marker wednesday. and it was truly miserable. i had no bm's at all during the test and became so severely impacted that on day 5 i started retaining urine and finally had to go to the ER where they catheterized me and pumped out over a liter and a half of urine. per gastro doc's orders, i'd been drinking lots of water in the hopes of keeping the backed up stool soft and instead the backed up stool began to block my urethra.the sitz xray showed all the markers scattered throughout the colon--none had passed since i'd had no bm's. gastro now has me scheduled for a follow up visit on 12/15 and in the meantime advised (via nurse through phone call) to keep up with my current regimen, taking whatever necessary to make me go. previous to the sitz (on the advice of my old gastro, now retired) i'd been taking milk of mag (works better for me than miralax) and stimulants (exlax or ducolax) to keep me going. at my first visit my current gastro had told me not to take all these laxatives. thankfully now he's done a complete 360 on this, having seen my sitz marker and the ER report --nothing like an er report to add some oomph to your file--lol.here is a really good article on the management of chronic constipation--complete with flow chart--love those flow charts. you will have to register on this site to read it but registration is free and well worth it since it's a terrific site with lots of sound authoritative info: http://www.medscape.com/viewarticle/746570good luck! hope you can find something that helps you..


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## em_t (Jun 8, 2010)

Hi Annie,Good to hear from you again. Sorry to hear you had to go through a Sitz marker test but at least the doctors now understand the extent of your condition. I've now had two Sitz marker tests done, one in February and one in April. The one in February showed that I had 59/60 markers still left inside me on day 6 and the second one showed that I had 16/60 left after using Resolor (a prokinetic drug licensed in the UK) for the duration of the test. So although the Resolor does indeed improve my transit time the result is still outside of the normal range. It also has not had any effect on the pain, bloating or nausea that I experience. I'm so sorry to hear about your ER visit - the same thing happened to me. Any time I get badly constipated I become unable to urinate although luckily have never had to be catheterised - just sent home with an enema and orders to take massive doses of Movicol!Unfortunately, I've had to go private in order to get a consultation with my gastroenterologist, the waiting list on the NHS was over 30 weeks, whereas privately I can get an appointment with him in 3 weeks!My doctor seems very reluctant to go down the surgical route so currently I am on a regimen of laxatives, including Movicol, micro-enemas that I administer every day and now erythromycin to try and induce gastric emptying, which it is hoped will also have an effect on my intestines as well!I'm slowly running out of options and my gastroenterologist admits I'm a unique case. He says if he finds a cure for me he wants to publish my case in a medical journal! On one hand I kinda think it's funny, but on the other just want to feel healthy again so I can get on with my life and return to work. Good luck all of you with Sitz mark tests and chronic C, I know how miserable it is!


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## annie7 (Aug 16, 2002)

Hi Em! great to hear from you! i've been wondering how you are doing. and yes i thought of you when i told the doc i wanted to do the sitz--it's just like you said--the docs take you more seriously once you've failed the sitz.those NHS waits are truly unbelievable! especially when one is in pain and needing relief. how on earth do they expect people to cope with that??so sorry you're still struggling with the chronic c problems and that you're such a unique case. you're so right--that's what we don't want to be--a unique case. we want a treatment plan that works so we will feel better and can get on with our lives.i do hope the ethro works for you. you so young to be having to deal with all this and you do so deserve a break! please keep me posted.wishing you all the best..


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## em_t (Jun 8, 2010)

Yeah, I definitely got the impression that once I had the transit test done that my doctors all took me much more seriously because they could "see" how bad it was. It's a horrible test to go through because those who do it tend to be laxative dependent so it can make for a pretty uncomfortable week - wouldn't be thrilled if I had to do another one!I'm getting on ok, still not working because of the pain and other symptoms but at least I've still got my sanity intact (just about!) The NHS waits are shocking and the crazy thing is if I were treated and well again I would be working and paying into the NHS via my taxes!Deffo not liking that I'm a unique case though. With most people with as bad transit problems with me they have usually been with them since childhood but mine started so suddenly after a bout of gastroenteritis, which is why it's so strange - most people have the opposite symptoms!Hoping the erythro works too, it's got some pretty nasty side effects I've been told but will just have to persevere over the next month to see if it makes a difference, but will keep you informed if it does make a difference!Hope you're keeping well (or as well as can be expected under the circumstances!)Em xx


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## annie7 (Aug 16, 2002)

Hi Emso sorry you haven't been able to go back to work. that must be really frustrating especially since you love teaching. but yes, like you said--at least you have your sanity intact--strong woman--that's half the battle.i'm ok thanks for asking. had a serious back injury this past summer which left me with a hypermobile sacrum and now i have to wear a sacroiliac belt across my lower pelvis 24/7 for life. needless to say this belt doesn't play well with chronic c. strapping it across a belly bloated with backed up stool and gas is not fun but at least it keeps my sacrum in place so it's worth it.one thing puzzled me when i was at the gastro doc's. he had a student gastro in there observing with him and when i said i wanted to do the sitz marker, he said ok but then he said to her that they--in that office--don't really do these tests much anymore. now i wish i'd spoken up at the time and asked why but he was talking to her more than to me so i felt reluctant to ask--unfortunately i have a bit of a tendency to clam up when i'm there probably because it was only my second visit. plan to ask him about that in the follow up.take care--hang in there! and yes, like you said (good way to put it) keep well--under the circumstances--annie xx


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## Bethesda7 (Feb 21, 2011)

I don't know if I am doing this properly. I know that if I had a sitz marker test i would end up in emergency for sure . I happen to know that after 40 years of this inability to defaecate without strong laxatives if I stopped taking laxatives I would totally block up. I know this because I have tried not taking anything and after about 3 days I am in severe agony and can't even walk. The doctors don't need to do a test for me to tell them that nothing moves my bowels and I mean nothing, except triple doses of laxatives. I know the alternative is to have my bowel completely removed but I don't want this operation and I don't particularly want a bag. I take 4 bisocodyl tablets one day and the next day a huge dose of magnesium oxide. this gets me going but I still have sluggish results, often wake up a lot through the night, spend many hours on the loo and suffer a heap of bloating and gas and the rumbles to the point where I am embarrassed to go out.I just go to my GP because there is no point going to a gastroenterologist who would only want to do a useless sitz marker.


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## em_t (Jun 8, 2010)

Bethesda7 said:


> I don't know if I am doing this properly. I know that if I had a sitz marker test i would end up in emergency for sure . I happen to know that after 40 years of this inability to defaecate without strong laxatives if I stopped taking laxatives I would totally block up. I know this because I have tried not taking anything and after about 3 days I am in severe agony and can't even walk. The doctors don't need to do a test for me to tell them that nothing moves my bowels and I mean nothing, except triple doses of laxatives. I know the alternative is to have my bowel completely removed but I don't want this operation and I don't particularly want a bag. I take 4 bisocodyl tablets one day and the next day a huge dose of magnesium oxide. this gets me going but I still have sluggish results, often wake up a lot through the night, spend many hours on the loo and suffer a heap of bloating and gas and the rumbles to the point where I am embarrassed to go out.I just go to my GP because there is no point going to a gastroenterologist who would only want to do a useless sitz marker.


I wouldn't say that the Sitz marker test is useless. It's a way that doctors can "see" how bad your problems are, as I often think that doctors think you are over-exaggerating your problems or they fail to realise quite how bad your problems are. I'm exactly the same as you, completely laxative dependent and I have had 2 Sitz mark tests done, one whilst taking no laxatives or prokinetic drugs and the second one whilst trialling a new drug, Resolor. I won't lie to you, it's no fun during that week but it's worth it if your doctors will take you seriously. No surgeon will carry out a colectomy or an ileostomy unless you have this test done anyway. The Resolor did indeed improve my transit however, having been on it continuously for about 8-9 months now I can safely say it's effects have worn off and my transit is as slow as it's ever been. I'm now being trialled on a whole regime of laxatives - both osmotic and stimulant, prokinetics, enemas and now antibiotics. If these don't work, I'm prepared to go down the surgical route as my symptoms mean that I rarely socialise, am unable to work and barely leave the house some days - which is no way to live. If you are really concerned about having a "bag" there is an operation they can do where they remove your bowel and connect your small intestine to your rectum, called a subtotal colectomy with ileorectal anastomosis, thus improving transit without the need for an external bag. What I mean to say, is there is hope but in order to access it you need to work with your gastroenterologist and have the necessary tests done. From my experience GPs often don't have enough knowledge to deal with these things themselves and you need a gastroenterologist, preferably one who specialises in motility disorders.


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## NOTSONUTSO (Dec 3, 2011)

Sean said:


> As I understand it, the Sitzmarker test is diagnostic for colonic inertia, which is just one form of constipation. A person could have a normal Sitzmark test and still have another form of constipation.All 24 markers were still in me after five days, so I got a definitive diagnosis of colonic inertia. I could have skipped the x-ray, however, as I knew that all of the markers were still in my colon. I had not had a bowel movement between the time I swallowed the capsule and the time of the x-ray. Considering that I couldn't take anything to move my bowels for a few days prior to taking the capsule, I was pretty miserable and impacted by the day on which I went for the x-ray of my colon. It is ironic that I finally got a diagnosis with a remarkably simple and non-invasive test after years of undergoing all of the usual invasive and uncomfortable tests like barium enemas, colonoscopies, flex sigs, rectal mannometry, etc. Ugh.


I have been on prescription laxative Kristalose since 2002. In 2007 it seemed to lose its effective so I discontinued it & drank bottle of magnesium citrate for almost 2 years until starting back on same dose of Kristalose (two 20 mgm powders mixed in 2 glasses of water). The stuff did not work as "well" as it did years ago but thankfully worked. (I started back on Kristalose after magnesium citrate barely worked any more) Now I am back to square one--the Kristalose is again not working. I have gone from "lazy colon" to COMATOSE colon! I drank 80 mgms of Kristalose twice last week (after regular dose did not work) NOTHING happened!! On Friday I drank 2-1/2 bottles of mag cit with very minimal results (anyone else would have been able to have colonoscopy). Took a break from fighting constipation on Saturday; then yesterday (Sunday) I drank two glasses of 20 mgm Kristalose powder (usual) dose. Got some results but wanted more so of course I double-dosed again (another 40 mgm). NOTHING! NOTHING! NOTHING! I was so bloated & stomach was gurgling but absolutely no results! So today I am taking another break from .. you know. I am no longer under the care of a gastroenterologist. My PCP (family dr.) is prescribing the Kristalose. I don't know what to do!!! I already suffer from chronic pain & the constipation makes it even more unbearable. Next week I am switching from the powder Kristalose to the "syrup." Does anyone know if this will help considering it's "new" albeit still Kristalose, same dose? I am becoming DESPERATE!!!


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## NOTSONUTSO (Dec 3, 2011)

Bethesda7 said:


> I don't know if I am doing this properly. I know that if I had a sitz marker test i would end up in emergency for sure . I happen to know that after 40 years of this inability to defaecate without strong laxatives if I stopped taking laxatives I would totally block up. I know this because I have tried not taking anything and after about 3 days I am in severe agony and can't even walk. The doctors don't need to do a test for me to tell them that nothing moves my bowels and I mean nothing, except triple doses of laxatives. I know the alternative is to have my bowel completely removed but I don't want this operation and I don't particularly want a bag. I take 4 bisocodyl tablets one day and the next day a huge dose of magnesium oxide. this gets me going but I still have sluggish results, often wake up a lot through the night, spend many hours on the loo and suffer a heap of bloating and gas and the rumbles to the point where I am embarrassed to go out.I just go to my GP because there is no point going to a gastroenterologist who would only want to do a useless sitz marker.


Wow, I can totally relate (read my post above). What are bisocodyl tablets? Are you on prescription laxative? Two bottles of magnesium citrate have almost no effect on me. I am becoming desperate!!!!


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