SITZMARKS PROTOCOL (rev. 1/17/19)
Instructions for Technologist - Simplified Sitzmarks Method
- 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.
Sitzmarks should not be used in patients with known or suspected hypersensitivity to barium sulfate or any component of Sitzmarks.
- 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.