Use of X-ray to Assess Fecal Loading in Patients with Gastrointestinal Symptoms

Pleasant, Versha; Sammarco, Anne G.; Keeney-Bonthrone, Grace; Bell, Sarah; Saad, Richard J.; Berger, Mitchell B.

doi:10.1007/s10620-019-05770-9

Cited by 6 publications

(10 citation statements)

References 31 publications

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“…Because of the low accuracy of self‐reported symptoms in certain clinical circumstances, abdominal radiography has been used by clinicians in assessing the severity of FL or stool burden in certain populations and clinical settings 9,20–23 . Despite the controversies on its usefulness in clinical practices, 24–26 using abdominal x‐ray in assessing stool burden is reliable among x‐ray readers and clinicians, 9,23,25 and is considered one of the tools in evaluating patients with a chief complaint of constipation 8 . Additionally, an abdominal x‐ray can be useful in clarifying uncertain situations, such as excessive bowel frequency resulting from excessive fecal burden 27 …”

Section: Discussionmentioning

confidence: 99%

“…9,[20][21][22][23] Despite the controversies on its usefulness in clinical practices, [24][25][26] using abdominal X-ray in assessing stool burden is reliable among X-ray readers and clinicians, 9,23,25 and is considered one of the tools in evaluating patients with a chief complaint of constipation. 8 Additionally, an abdominal X-ray can be useful in clarifying uncertain situations, such as excessive bowel frequency resulting from excessive fecal burden. There are several limitations in this study that should be acknowledged.…”

Section: Discussionmentioning

confidence: 99%

“…There are limited data regarding what constitutes “normal distribution” of feces in the colon of adults 8 . The purpose of this study is to analyze the FL distribution patterns observed by abdominal x‐ray, based on the FL scores in the segment of AC and DC.…”

Section: Introductionmentioning

confidence: 99%

“…There are limited data regarding what constitutes "normal distribution" of feces in the colon of adults. 8 The purpose of this study is to analyze the FL distribution patterns observed by abdominal X-ray, based on the FL scores in the segment of AC and DC. In addition, this study also purports to identify factors associated with a particular stool retention pattern (for example, high FL in AC and low in DC) among a cohort of patients who underwent abdominal X-ray in the hospital setting.…”

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confidence: 99%

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Analyzing fecal loading and retention patterns by abdominal X‐rays of hospitalized older adults: A retrospective study

et al. 2022

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Background Aging may affect ascending colon (AC) differently from descending colon (DC) and increase the risk of fecal loading (FL) in AC. Methods Patients aged ≥65 years admitted to a community hospital were analyzed by abdominal x‐ray for fecal loads and stool retention patterns. FL was scored between 0 and 5 (severe) on each segment of colon with a possible total score 20. Mean segment scores ≥3.5 were designated as high scores for both AC and DC. Logistic regression was performed between groups to identify factors associated with FL patterns. Results Groups identified were high FL in both AC and DC (N = 21, 17.2%), FL predominantly in AC (N = 38, 31.1%), low FL in both AC and DC (N=60, 49.2%), and FL low in AC and high in DC (N = 3, 2.5%). Among 71 patients with total FL scores ≥13 (indicating significant stool retention), 37 (52.1%) had the FL predominantly in AC. Patients prescribed antibiotic(s) prior to hospitalization had lower odds of FL predominantly in AC (adjusted odds ratio = 0.18, 95% confidence interval = 0.04–0.84) compared to the group of low FL in both AC and DC with the adjustment of confounders. Conclusion This study found that 52.1% of those with significant stool retention on x‐ray had the FL predominantly in AC. Antibiotic use was associated with lower odds of having FL predominately in AC. This study provided insights of FL distribution in colon and AC could be an area for significant stool burden in older adults with stool retention.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Analyzing fecal loading and retention patterns by abdominal X‐rays of hospitalized older adults: A retrospective study

et al. 2022

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“…In this issue of Digestive Diseases and Sciences, Pleasant et al [3] reported a retrospective study of 319 adult patients (median age 57.9 years, and predominantly female) who were seen by a gastroenterologist or urogynecologist at the University of Michigan between 2005 and 2017, and who underwent an abdominal X-ray for assessment of fecal loading. The authors investigated the association between radiographic fecal burden (which was determined on the basis of "fecal loading" or "fecal matter" in the radiology report) and clinically reported patient symptoms, focusing on clinical symptoms of constipation, diarrhea, bloating, and accidental bowel leakage.…”

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confidence: 99%

Taking a Load Off Diagnosing Constipation: Utility of the Plain Film

Rangan

2019

Dig Dis Sci

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Meta‐analysis: Intestinal ultrasound to evaluate colonic contents and constipation

Mathias,

Chu,

Edwards

et al. 2024

Aliment Pharmacol Ther

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SummaryBackgroundConstipation can be diagnosed clinically using the Rome criteria. Ultrasound (US), which lacks the radiation exposure of conventional X‐ray, holds promise as a non‐invasive tool to evaluate colonic contents and constipation.AimTo examine the role of US in the assessment of constipation.MethodsWe performed a systematic search of Embase (OVID, 1984), Medline (Ovid, 1946), Cochrane Central, ClinicalTrials.gov and Australia New Zealand Clinical Trials Registry from database inception to 26 January 2024 according to PRISMA guidelines and prospectively registered with PROSPERO. All studies using US to assess constipation or colonic contents in either adults or children were included. Rectal diameter measurements were pooled in meta‐analysis. Risk of bias was assessed using the Newcastle Ottawa Scales and Joanna Briggs Institute checklists.ResultsOf 12,232 studies screened, 51 articles (6084 patients; 3422 children) describing US to assess symptoms in patients with constipation were included. Most studies used Rome criteria to diagnose constipation. Rectal diameter was associated with clinical constipation in 29 paediatric studies (3331 patients). Meta‐analysis showed the mean rectal diameter of constipated patients was significantly higher than controls (mean difference 12 mm, 95% confidence intervals (CI): 6.48, 17.93, p < 0.0001, n = 16 studies). Other features of constipation on US included posterior acoustic shadowing and echogenicity of luminal contents.ConclusionUS is an appealing imaging modality to assess luminal contents and constipation. Further well‐designed studies are required to validate US metrics that accurately identify constipation.

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Use of X-ray to Assess Fecal Loading in Patients with Gastrointestinal Symptoms

Cited by 6 publications

References 31 publications

Analyzing fecal loading and retention patterns by abdominal X‐rays of hospitalized older adults: A retrospective study

Analyzing fecal loading and retention patterns by abdominal X‐rays of hospitalized older adults: A retrospective study

Taking a Load Off Diagnosing Constipation: Utility of the Plain Film

Meta‐analysis: Intestinal ultrasound to evaluate colonic contents and constipation

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