SITZMARKS PROTOCOL (rev. 1/17/19)
Instructions for Technologist - Simplified Sitzmarks Method
- SCOUT RADIOGRAPH
- One capsule = 24 markers
- On day 1, direct patient to take one SITZMARKS capsule by mouth with water, preferably with confirmation by office observation. Instruct patient to use no laxatives, enemas or suppositories for 5 days.
- Arrange a flat plate abdominal X-ray on day 5 to determine the location and extent of elimination of the radiopaque markers.
- Patients who expel at least 80% (19 or more) of the markers have grossly normal colonic transit.
Instructions for Radiologist:- When over 80% (19 or more) of the markers are passed, colonic transit is not grossly abnormal.
- 5 rings or less should be left in the colon/rectum
- When remaining markers are scattered about the colon, condition is most likely hypomotility or colonic inertia.
- When remaining markers are accumulated in the rectum or rectosigmoid, the condition is most likely functional outlet delay, e.g., internal rectal prolapse, anismus.
- When over 80% (19 or more) of the markers are passed, colonic transit is not grossly abnormal.
- 5 rings or less should be left in the colon/rectum
- When remaining markers are scattered about the colon, condition is most likely hypomotility or colonic inertia.
- When remaining markers are accumulated in the rectum or rectosigmoid, the condition is most likely functional outlet delay, e.g., internal rectal prolapse, anismus.
CONTRAINDICATIONS:
Sitzmarks should not be used in patients with known or suspected hypersensitivity to barium sulfate or any component of Sitzmarks.
References:- Lin HC, Prather C, Fisher RS et-al. Measurement of gastrointestinal transit. Dig. Dis. Sci. 2005;50 (6): 989-1004.
- Southwell BR, Clarke MC, Sutcliffe J et-al. Colonic transit studies: normal values for adults and children with comparison of radiological and scintigraphic methods. Pediatr. Surg. Int. 2009;25 (7): 559-72.
- Lembo A, Camilleri, M. Chronic Constipation. NEJM 2003: 349: 1360-8.
