Longer colonic transit time is associated with laxative and drug use, lifestyle factors, and symptoms of constipation

Acta Radiol Open. 2018 Oct 22;7(10):2058460118807232. doi: 10.1177/2058460118807232. eCollection 2018 Sep.


Background: Gastrointestinal symptoms and changes in colonic transit time (CTT) are common in the population.

Purpose: To evaluate consecutive patients who had been examined for CTT, along with completion of a diary about laxative and drug use, lifestyle factors, and gastrointestinal symptoms, to identify possible associations with longer or prolonged CTT.

Material and methods: A total of 610 consecutive patients had undergone the radiopaque marker method with an abdominal X-ray for clinical purposes. The patients had completed a diary regarding medical treatment, lifestyle factors, stool habits, and their perceived constipation and abdominal pain during the examination period. The associations between CTT and laxative use, lifestyle factors, stool habits, and symptoms were calculated by logistic regression.

Results: Women had longer CTT (2.5 [1.6-3.9] vs. 1.7 [1.1-3.0] days, P < 0.001), lower weekly stool frequency (6 [3-10] vs. 8 [5-12], P = 0.001), and perceived more constipation (P = 0.025) and abdominal pain (P = 0.001) than men. High coffee consumption (P = 0.045), bulk-forming (P = 0.007) and osmotic (P = 0.001) laxatives, and lower stool frequency, shaped stool, and perceived constipation (P for trend < 0.001) were associated with longer CTT. In total, 382 patients (63%) were treated with drugs affecting motility. In the 228 patients without drug treatment, longer CTT was associated with female sex and smoking, and lower frequency of symptoms and prolonged CTT were observed compared to patients using drugs. Tea, alcohol, and abdominal pain did not associate with CTT.

Conclusions: Female sex, coffee, smoking, drug use, infrequent stools, shaped stool, and perception of constipation are associated with longer or prolonged CTT.

Keywords: Colonic transit time; constipation; functional gastrointestinal disorders (FGID); laxatives; lifestyle factors.