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. 1996 Aug;39(2):299–305. doi: 10.1136/gut.39.2.299

Variability of gastrointestinal transit in healthy women and men.

L P Degen 1, S F Phillips 1
PMCID: PMC1383315  PMID: 8977347

Abstract

BACKGROUND AND AIMS: Measurements of gastrointestinal transit are made in clinical and research gastroenterology, yet their intrinsic variability is not well characterised. In particular, an influence of hormones on transit has been proposed as the basis for gastrointestinal symptoms that vary with the menstrual cycle. Our aims were to quantify individual differences in transit during the menstrual cycle in healthy women and to compare these with the intrinsic variability in healthy men. METHODS: On two occasions, whole gut transit was assessed scintigraphically and colonic transit quantified by radio-opaque markers. Thirty two healthy volunteers (12 women, 20 men) were studied, women during the follicular and luteal phases, men twice within a similar four week period. Diets and exercise were standardised prior to and during both studies. RESULTS: Colonic transit was significantly faster in men, and postlag gastric emptying was also more rapid; other indices of regional transit were not different between the sexes. Total colonic transit time was equally well reflected by the scintigraphic and radio-opaque marker methods. Important intraindividual differences were noted in both sexes. The variances in our samples predicted an 80% chance of detecting (with 95% confidence) a mean effect of menstrual hormones on transit that was in the same range as the intrinsic variation in men. CONCLUSIONS: Colonic transit was faster in men than in women. Although group means in the two studies were almost identical, single assessments of transit in subjects sometimes exhibited considerable variability, implying broad biological variations. Given this intrinsic variability, the influence of menstrual hormones on gastrointestinal transit must be small and of doubtful clinical significance.

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Selected References

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  1. Anderson J. W., Bridges S. R. Dietary fiber content of selected foods. Am J Clin Nutr. 1988 Mar;47(3):440–447. doi: 10.1093/ajcn/47.3.440. [DOI] [PubMed] [Google Scholar]
  2. Arhan P., Devroede G., Jehannin B., Lanza M., Faverdin C., Dornic C., Persoz B., Tétreault L., Perey B., Pellerin D. Segmental colonic transit time. Dis Colon Rectum. 1981 Nov-Dec;24(8):625–629. doi: 10.1007/BF02605761. [DOI] [PubMed] [Google Scholar]
  3. Basilisco G., Camboni G., Bozzani A., Vita P., Doldi S., Bianchi P. A. Orocecal transit delay in obese patients. Dig Dis Sci. 1989 Apr;34(4):509–512. doi: 10.1007/BF01536325. [DOI] [PubMed] [Google Scholar]
  4. Bisdee J. T., Garlick P. J., James W. P. Metabolic changes during the menstrual cycle. Br J Nutr. 1989 May;61(3):641–650. doi: 10.1079/bjn19890151. [DOI] [PubMed] [Google Scholar]
  5. Brophy C. M., Moore J. G., Christian P. E., Egger M. J., Taylor A. T. Variability of gastric emptying measurements in man employing standardized radiolabeled meals. Dig Dis Sci. 1986 Aug;31(8):799–806. doi: 10.1007/BF01296046. [DOI] [PubMed] [Google Scholar]
  6. Bruce L. A., Behsudi F. M., Danhof I. E. Smooth muscle mechanical responses in vitro to bethanechol after progesterone in male rat. Am J Physiol. 1978 Oct;235(4):E422–E428. doi: 10.1152/ajpendo.1978.235.4.E422. [DOI] [PubMed] [Google Scholar]
  7. Bruce L. A., Behsudi F. M. Differential inhibition of regional gastrointestinal tissue to progesterone in the rat. Life Sci. 1980 Aug 4;27(5):427–434. doi: 10.1016/0024-3205(80)90192-7. [DOI] [PubMed] [Google Scholar]
  8. Bruce L. A., Behsudi F. M. Progesterone effects on three regional gastrointestinal tissues. Life Sci. 1979 Aug 27;25(9):729–734. doi: 10.1016/0024-3205(79)90515-0. [DOI] [PubMed] [Google Scholar]
  9. Bruce L. A., Beshudi F. M. Increased gastrointestinal motility in vitro following chronic estrogen treatment in male rats. Proc Soc Exp Biol Med. 1981 Mar;166(3):355–359. doi: 10.3181/00379727-166-41073. [DOI] [PubMed] [Google Scholar]
  10. Camilleri M., Colemont L. J., Phillips S. F., Brown M. L., Thomforde G. M., Chapman N., Zinsmeister A. R. Human gastric emptying and colonic filling of solids characterized by a new method. Am J Physiol. 1989 Aug;257(2 Pt 1):G284–G290. doi: 10.1152/ajpgi.1989.257.2.G284. [DOI] [PubMed] [Google Scholar]
  11. Camilleri M., Zinsmeister A. R., Greydanus M. P., Brown M. L., Proano M. Towards a less costly but accurate test of gastric emptying and small bowel transit. Dig Dis Sci. 1991 May;36(5):609–615. doi: 10.1007/BF01297027. [DOI] [PubMed] [Google Scholar]
  12. Camilleri M., Zinsmeister A. R. Towards a relatively inexpensive, noninvasive, accurate test for colonic motility disorders. Gastroenterology. 1992 Jul;103(1):36–42. doi: 10.1016/0016-5085(92)91092-i. [DOI] [PubMed] [Google Scholar]
  13. Cann P. A., Read N. W., Brown C., Hobson N., Holdsworth C. D. Irritable bowel syndrome: relationship of disorders in the transit of a single solid meal to symptom patterns. Gut. 1983 May;24(5):405–411. doi: 10.1136/gut.24.5.405. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Charles F., Camilleri M., Phillips S. F., Thomforde G. M., Forstrom L. A. Scintigraphy of the whole gut: clinical evaluation of transit disorders. Mayo Clin Proc. 1995 Feb;70(2):113–118. doi: 10.4065/70.2.113. [DOI] [PubMed] [Google Scholar]
  15. Collins P. J., Horowitz M., Cook D. J., Harding P. E., Shearman D. J. Gastric emptying in normal subjects--a reproducible technique using a single scintillation camera and computer system. Gut. 1983 Dec;24(12):1117–1125. doi: 10.1136/gut.24.12.1117. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Connell A. M., Hilton C., Irvine G., Lennard-Jones J. E., Misiewicz J. J. Variation of bowel habit in two population samples. Br Med J. 1965 Nov 6;2(5470):1095–1099. doi: 10.1136/bmj.2.5470.1095. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Cummings J. H., Wiggins H. S. Transit through the gut measured by analysis of a single stool. Gut. 1976 Mar;17(3):219–223. doi: 10.1136/gut.17.3.219. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Datta S., Hey V. M., Pleuvry B. J. Effects of pregnancy and associated hormones in mouse intestine, in vivo and in vitro. Pflugers Arch. 1974 Feb 4;346(2):87–95. doi: 10.1007/BF00587009. [DOI] [PubMed] [Google Scholar]
  19. Datz F. L., Christian P. E., Moore J. Gender-related differences in gastric emptying. J Nucl Med. 1987 Jul;28(7):1204–1207. [PubMed] [Google Scholar]
  20. Davies G. J., Crowder M., Reid B., Dickerson J. W. Bowel function measurements of individuals with different eating patterns. Gut. 1986 Feb;27(2):164–169. doi: 10.1136/gut.27.2.164. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Derogatis L. R., Rickels K., Rock A. F. The SCL-90 and the MMPI: a step in the validation of a new self-report scale. Br J Psychiatry. 1976 Mar;128:280–289. doi: 10.1192/bjp.128.3.280. [DOI] [PubMed] [Google Scholar]
  22. Evans R. C., Kamm M. A., Hinton J. M., Lennard-Jones J. E. The normal range and a simple diagram for recording whole gut transit time. Int J Colorectal Dis. 1992 Feb;7(1):15–17. doi: 10.1007/BF01647654. [DOI] [PubMed] [Google Scholar]
  23. Gill R. C., Bowes K. L., Kingma Y. J. Effect of progesterone on canine colonic smooth muscle. Gastroenterology. 1985 Jun;88(6):1941–1947. doi: 10.1016/0016-5085(85)90023-x. [DOI] [PubMed] [Google Scholar]
  24. Heaton K. W., Radvan J., Cripps H., Mountford R. A., Braddon F. E., Hughes A. O. Defecation frequency and timing, and stool form in the general population: a prospective study. Gut. 1992 Jun;33(6):818–824. doi: 10.1136/gut.33.6.818. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Heitkemper M. M., Jarrett M. Pattern of gastrointestinal and somatic symptoms across the menstrual cycle. Gastroenterology. 1992 Feb;102(2):505–513. doi: 10.1016/0016-5085(92)90097-i. [DOI] [PubMed] [Google Scholar]
  26. Hinds J. P., Stoney B., Wald A. Does gender or the menstrual cycle affect colonic transit? Am J Gastroenterol. 1989 Feb;84(2):123–126. [PubMed] [Google Scholar]
  27. Hinton J. M., Lennard-Jones J. E., Young A. C. A ne method for studying gut transit times using radioopaque markers. Gut. 1969 Oct;10(10):842–847. doi: 10.1136/gut.10.10.842. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Horowitz M., Collins P. J., Cook D. J., Harding P. E., Shearman D. J. Abnormalities of gastric emptying in obese patients. Int J Obes. 1983;7(5):415–421. [PubMed] [Google Scholar]
  29. Horowitz M., Maddern G. J., Chatterton B. E., Collins P. J., Petrucco O. M., Seamark R., Shearman D. J. The normal menstrual cycle has no effect on gastric emptying. Br J Obstet Gynaecol. 1985 Jul;92(7):743–746. doi: 10.1111/j.1471-0528.1985.tb01458.x. [DOI] [PubMed] [Google Scholar]
  30. Hutson W. R., Roehrkasse R. L., Wald A. Influence of gender and menopause on gastric emptying and motility. Gastroenterology. 1989 Jan;96(1):11–17. doi: 10.1016/0016-5085(89)90758-0. [DOI] [PubMed] [Google Scholar]
  31. Kamm M. A., Farthing M. J., Lennard-Jones J. E. Bowel function and transit rate during the menstrual cycle. Gut. 1989 May;30(5):605–608. doi: 10.1136/gut.30.5.605. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. La Brooy S. J., Male P. J., Beavis A. K., Misiewicz J. J. Assessment of the reproducibility of the lactulose H2 breath test as a measure of mouth to caecum transit time. Gut. 1983 Oct;24(10):893–896. doi: 10.1136/gut.24.10.893. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Lawaetz O., Dige-Petersen H. Gastric emptying of liquid meals. A study in 88 normal persons. Ann Chir Gynaecol. 1989;78(4):267–276. [PubMed] [Google Scholar]
  34. Lawson M., Everson G. T., Klingensmith W., Kern F., Jr Coordination of gastric and gallbladder emptying after ingestion of a regular meal. Gastroenterology. 1983 Oct;85(4):866–870. [PubMed] [Google Scholar]
  35. Lee I. M., Paffenbarger R. S., Jr, Hsieh C. C. Time trends in physical activity among college alumni, 1962-1988. Am J Epidemiol. 1992 Apr 15;135(8):915–925. doi: 10.1093/oxfordjournals.aje.a116387. [DOI] [PubMed] [Google Scholar]
  36. Levitt M. D. Production and excretion of hydrogen gas in man. N Engl J Med. 1969 Jul 17;281(3):122–127. doi: 10.1056/NEJM196907172810303. [DOI] [PubMed] [Google Scholar]
  37. Manning A. P., Thompson W. G., Heaton K. W., Morris A. F. Towards positive diagnosis of the irritable bowel. Br Med J. 1978 Sep 2;2(6138):653–654. doi: 10.1136/bmj.2.6138.653. [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. Meier R., Beglinger C., Dederding J. P., Meyer-Wyss B., Fumagalli M., Rowedder A., Turberg Y., Brignoli R. Influence of age, gender, hormonal status and smoking habits on colonic transit time. Neurogastroenterol Motil. 1995 Dec;7(4):235–238. doi: 10.1111/j.1365-2982.1995.tb00231.x. [DOI] [PubMed] [Google Scholar]
  39. Metcalf A. M., Phillips S. F., Zinsmeister A. R., MacCarty R. L., Beart R. W., Wolff B. G. Simplified assessment of segmental colonic transit. Gastroenterology. 1987 Jan;92(1):40–47. doi: 10.1016/0016-5085(87)90837-7. [DOI] [PubMed] [Google Scholar]
  40. Monés J., Carrió I., Calabuig R., Estorch M., Sainz S., Berná L., Vilardell F. Influence of the menstrual cycle and of menopause on the gastric emptying rate of solids in female volunteers. Eur J Nucl Med. 1993 Jul;20(7):600–602. doi: 10.1007/BF00176554. [DOI] [PubMed] [Google Scholar]
  41. Notivol R., Carrio I., Cano L., Estorch M., Vilardell F. Gastric emptying of solid and liquid meals in healthy young subjects. Scand J Gastroenterol. 1984 Nov;19(8):1107–1113. [PubMed] [Google Scholar]
  42. Proano M., Camilleri M., Phillips S. F., Brown M. L., Thomforde G. M. Transit of solids through the human colon: regional quantification in the unprepared bowel. Am J Physiol. 1990 Jun;258(6 Pt 1):G856–G862. doi: 10.1152/ajpgi.1990.258.6.G856. [DOI] [PubMed] [Google Scholar]
  43. Rao S. S., Read N. W., Brown C., Bruce C., Holdsworth C. D. Studies on the mechanism of bowel disturbance in ulcerative colitis. Gastroenterology. 1987 Nov;93(5):934–940. doi: 10.1016/0016-5085(87)90554-3. [DOI] [PubMed] [Google Scholar]
  44. Scarpello J. H., Barber D. C., Hague R. V., Cullen D. R., Sladen G. E. Gastric emptying of solid meals in diabetics. Br Med J. 1976 Sep 18;2(6037):671–673. doi: 10.1136/bmj.2.6037.671. [DOI] [PMC free article] [PubMed] [Google Scholar]
  45. Simmons L., Heitkemper M., Shaver J. Gastrointestinal function during the menstrual cycle. Health Care Women Int. 1988;9(3):201–209. doi: 10.1080/07399338809515818. [DOI] [PubMed] [Google Scholar]
  46. Stephen A. M., Wiggins H. S., Englyst H. N., Cole T. J., Wayman B. J., Cummings J. H. The effect of age, sex and level of intake of dietary fibre from wheat on large-bowel function in thirty healthy subjects. Br J Nutr. 1986 Sep;56(2):349–361. doi: 10.1079/bjn19860116. [DOI] [PubMed] [Google Scholar]
  47. Stivland T., Camilleri M., Vassallo M., Proano M., Rath D., Brown M., Thomforde G., Pemberton J., Phillips S. Scintigraphic measurement of regional gut transit in idiopathic constipation. Gastroenterology. 1991 Jul;101(1):107–115. doi: 10.1016/0016-5085(91)90466-x. [DOI] [PubMed] [Google Scholar]
  48. Turnbull G. K., Thompson D. G., Day S., Martin J., Walker E., Lennard-Jones J. E. Relationships between symptoms, menstrual cycle and orocaecal transit in normal and constipated women. Gut. 1989 Jan;30(1):30–34. doi: 10.1136/gut.30.1.30. [DOI] [PMC free article] [PubMed] [Google Scholar]
  49. Vassallo M., Camilleri M., Phillips S. F., Brown M. L., Chapman N. J., Thomforde G. M. Transit through the proximal colon influences stool weight in the irritable bowel syndrome. Gastroenterology. 1992 Jan;102(1):102–108. doi: 10.1016/0016-5085(92)91789-7. [DOI] [PubMed] [Google Scholar]
  50. Wald A., Van Thiel D. H., Hoechstetter L., Gavaler J. S., Egler K. M., Verm R., Scott L., Lester R. Gastrointestinal transit: the effect of the menstrual cycle. Gastroenterology. 1981 Jun;80(6):1497–1500. [PubMed] [Google Scholar]
  51. Whitehead W. E., Cheskin L. J., Heller B. R., Robinson J. C., Crowell M. D., Benjamin C., Schuster M. M. Evidence for exacerbation of irritable bowel syndrome during menses. Gastroenterology. 1990 Jun;98(6):1485–1489. doi: 10.1016/0016-5085(90)91079-l. [DOI] [PubMed] [Google Scholar]
  52. Wright R. A., Krinsky S., Fleeman C., Trujillo J., Teague E. Gastric emptying and obesity. Gastroenterology. 1983 Apr;84(4):747–751. [PubMed] [Google Scholar]
  53. Wyman J. B., Heaton K. W., Manning A. P., Wicks A. C. Variability of colonic function in healthy subjects. Gut. 1978 Feb;19(2):146–150. doi: 10.1136/gut.19.2.146. [DOI] [PMC free article] [PubMed] [Google Scholar]

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