Measurement ofintestinal progression ofamealandits residues innormal subjects andpatients withfunctional diarrhoea byadualisotope technique

SUMMARY A new doubleisotopic methodwas usedtomeasure thegastrointestinal progression ofa mealinninehealthy subjects andseven patients withfunctional diarrhoea. 51Chromium chloride (colonic marker) was ingested eight hoursbefore thebeginning ofthescintigraphic study sothat it was bythenlocated inthecolon atthattime. A second marker, 99mTechnetium sulphur colloid labelled themeal.Scintigraphic images were takenbefore andafter themealfortwo hours, detecting simultaneously thetwoisotopes. Inthe51Crwindowright colon was localised andintracolonic propulsion was studied; andinthe99mTcwindowgastric emptying andcolon filling ofthemealmarker was quantified. A propulsive gastrocolic reflex was evidenced infive of theseven patients withfunctional diarrhoea butinnone ofthenormalsubjects. Unabsorbed residues ofthemealarepropelled rapidly intheileocaecal region. Smallintestinal transit ofthe mealmarker was twice asrapid inpatients withfunctional diarrhoea asinnormalsubjects. Thereisnoaccurate methodtomeasure thetransit ofamealthrough thegutinman.Bariumstudies givenon-quantitative andunphysiological results. Themouthtoanustransit timeofnon-digestible markers orpellets' 2reflects essentially intracolonic propulsion andnotthemorerapidsmallbowel transit. Intestinal progression ofatelemetric oran isotopically labelled capsule3 isnotnecessarily related tothatofa normally ingested food.The technique using slowinfusion ofanon-absorbable marker allows measurement ofintraluminal outputs atanypointofthegutandthusintraluminal