# The tests I have had



## 16138 (Jun 4, 2005)

Anyone ever feel like all they do is go to the hospital for test after test? That is how I felt for the 2 years leading up to my surgery. Anyway I thought I would post here about the tests I had since some of them are not so common. A lot of people on here seem to be asking about specific tests so I thought I'd post the information I have about all of my tests. My dx was idiopathic colonic inertia and I had a total abdominal colectomy with ileorectal anastomosis on 9/29/04. Here are the tests I had:Flexible sigmopidoscopy or ColonoscopyBarium Enema (if you have a colonoscopy done then you probably will not require this)Gastric Emptying (to see how quickly the food moves through the stomach and into the small bowel - this test rules out gastroparesis and other disorders involving the small bowel) Defecography (to see how the colon expels feces...to rule out any outlet obstruction and pelvic floor disorders)Manometry (to test the pressure in the intestine and rectum and again to rule out outlet obstruction) Biofeedback - (This is a type of therapy that I was given -To see if I was pushing and contracting the anal sphincter correctly when trying to have a BM) Sitzmarker (To see how long it took for the colon to move things along --this is the definitive test for inertia)Here is some more in depth information about these tests (taken from medicinenet.com):Barium enema: A barium enema (lower GI series) is an x-ray study in which liquid barium is inserted through the anus to fill the rectum and colon. The barium outlines the colon on the x-rays and defines the normal or abnormal anatomy of the colon and rectum. Tumors and narrowings (strictures) are among the abnormalities that can be detected with this test.Colonic transit (marker) studies: Colonic transit studies are simple x-ray studies that determine how long it takes for food to travel through the intestines. For transit studies, individuals swallow capsules for one or more days. Inside the capsules are many small pieces of plastic that can be seen on x-rays. The gelatin capsules dissolve and release the plastic pieces into the small intestine. The pieces of plastic then travel (as would digesting food) through the small intestine and into the colon. After 5 or 7 days, an x-ray of the abdomen is taken and the pieces of plastic in the different parts of the colon are counted. From this count, it is possible to determine if and where there is a delay in the colon. In non-constipated individuals, all of the plastic pieces are eliminated in the stool and none remain in the colon. When pieces are spread throughout the colon, it suggests that the muscles and/or nerves throughout the colon are not working, which is typical of colonic inertia. When pieces accumulate in the rectum, it suggests pelvic floor dysfunction.Defecography: Defecography is a modification of the barium enema examination. For this procedure, a thick paste of barium is inserted into the rectum of a patient through the anus. X-rays then are taken while the patient defecates the barium. The barium clearly outlines the rectum and anus and demonstrates the changes taking place in the muscles of the pelvic floor during defecation. Thus, defecography examines the process of defecation and provides information about anatomical abnormalities of the rectum and pelvic floor muscles during defecation.Ano-rectal motility studies: Ano-rectal motility studies, which complement defecography tests, provide an assessment of the function of the muscles and nerves of the anus and rectum. For ano-rectal motility studies, a flexible tube, approximately an eighth of an inch in diameter, is inserted through the anus and into the rectum. Sensors within the tube measure the pressures that are generated by the muscles of the anus and rectum. With the tube in place, the patient performs several simple maneuvers such as voluntarily tightening the anal muscles. Ano-rectal motility studies can help determine if the muscles of the anus and rectum are working normally. When the function of these muscles is impaired, the flow of stool is obstructed, thereby causing a condition similar to pelvic floor dysfunction.Colonic motility studies: Colonic motility studies are similar to ano-rectal motility studies in many aspects. A very long, narrow (one-eighth inch in diameter), flexible tube is inserted through the anus and passed through part or all of the colon during a procedure called colonoscopy. Sensors within the tube measure the pressures that are generated by the contractions of the colonic muscles. These contractions are the result of coordinated activity of the colonic nerves and muscles. If the activity of the nerves or muscles is abnormal, the pattern of colonic pressures will be abnormal. Colonic motility studies are most useful in defining colonic inertia. These studies are considered research tools, but they can be helpful in making decisions regarding treatment in patients with severe constipation.I hope this post is helpful to someone who is lookign for info about any of these tests.


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## 21731 (Jul 12, 2006)

*THANK YOU* for this wealth of information!!! I see that it's been quite some time since you posted this information. I hope by upping this thread that others with many questions find the answers here, I know I did!!!My colorectal specialist is wanting to do two more tests before he makes a final decision to move forward with surgery.1) A 7 day transit study2) Ano-rectal motility studyMy GI set me up with the colorectal specialist after my defagram showed an extremely large rectocele and because I wasn't able to "move" the barium balloon that was inserted during the defagram.I explained that I've suffered with chronic constipation my entire life, that I was hospitalized when I was 15 months old, now I'm 43, and that within the last eight or nine months, nothing wants to move. The colonoscopy that the GI performed revealed a lot of looping of the colon, but other than that it looked pretty good.Since July I've been taking my daily poop potion which consists of Miralax and Lactalose. I also tried Zelnorm, but it didn't work. At first, the poop potion seemed to move things along (although I never felt completely empty AND wasn't empty). In the last two weeks - The poop potion isn't working very well at all. I've tried doubling up on the Miralax with very little success - the only thing I seem to pass is gas and it is very foul smelling to put it lightly.Well, I am very thankful to you for posting all the information regarding the various tests and the purposes of these tests.


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