title: Evaluation of constipation in older adults: radioopaque markers (ROMs) versus wireless motility capsule (WMC).
abstract: There is scarce information regarding assessment of constipation in older subjects. We examined regional and whole-gut transit time (WGTT) with wireless motility capsule (WMC) and compared this with radioopaque markers (ROM) transit. 39 constipated and 11 healthy older subjects (≥ 65 years) ingested a ROM capsule and WMC, wore a data receiver and kept stool diaries for 5 days. WMC recordings were analyzed for colonic transit time (CTT), WGTT and gastric emptying time (GET). Radiographs obtained on day 5 assessed ROM transit. Results for each device were compared. The CTT (p = <0.0001), WGTT (p = <0.001) and GET (p = <0.04) as measured by WMC were all slower in constipated subjects compared to healthy subjects. ROM colonic transit was also slower (p = <0.007) in constipated compared to healthy subjects. The diagnostic utility for identifying subjects with constipation as assessed by receiver operating characteristics were similar; 0.85 (WMC) versus 0.73 (ROM). Device agreement for slow colonic transit was 88% with good correlation between WMC and ROM (CTT r=0.718, p=0.0001, WGTT r=0.693, p=0.0001). Slow transit constipation was identified in 28% with ROM and 32% with WMC. No adverse events were recorded. WMC is a safe and useful device that provides objective diagnosis of delayed colonic and whole gut transit in older constipated adults. It is a radiation-free, physiologic and ambulatory technique that provides additional diagnostic information than ROM.
authors.affiliation: Section of Gastroenterology and Hepatology, Georgia Health Sciences University, Medical College of Georgia, 1120 15th Street, Augusta, GA 30912, USA. srao@georgiahealth.edu
authors.forename: S S C
authors.initials: SS
authors.lastname: Rao
authors.forename: E
authors.initials: E
authors.lastname: Coss-Adame
authors.forename: J
authors.initials: J
authors.lastname: Valestin
authors.forename: K
authors.initials: K
authors.lastname: Mysore
mesh_terms: D000368:Aged; D053704:Capsule Endoscopy / Q000379:methods*; D003248:Constipation / Q000175:diagnosis*; D003287:Contrast Media; D005260:Female; D005769:Gastrointestinal Motility / Q000502:physiology; D006801:Humans; D008297:Male; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media