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for Use

Healthcare Provider Information

Doctor and patient

Indications for Use

SITZMARKS capsule is a diagnostic test indicated for aiding in the evaluation of colonic motility in patients with severe constipation, as diagnosed by your healthcare professional, but otherwise negative GI evaluations. SITZMARKS capsule, for use in adult and pediatric patients (at least 2 years old), is to be dispensed only by physicians to patients for oral intake.

Pediatric Instructions

Ensure that children are able to swallow a capsule of this size. Alternative methods for those who cannot swallow the capsule include opening the capsule and emptying the contents into applesauce (or other similar food).

Simplified SITZMARKS® Method

(1 capsule: each capsule with 24 markers)

Use the Simplified SITZMARKS Method to assess colonic transit time, detect outlet dysfunction, blockage, or colonic inertia in a constipated patient.

Step A

  1. 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.

  2.  Arrange a flat plate abdominal X-ray on day 5 to determine the location and extent of elimination of the radiopaque markers.

  3.  Patients who expel at least 80% (19 or more) of the markers have grossly normal colonic transit.

  4.  Patients who retain 6 or more markers may have a follow-up abdominal x-ray within several days.

  5.  For patients whose markers accumulate in the rectosigmoid, or when markers are retained diffusely, Step B may be warranted.

Step B

  1. Have patient take a bulking agent (such as Konsyl Daily Psyllium Fiber) daily for 1 to 2 weeks. Encourage liquid intake to maximize product efficacy.

  2.  Have patient take another SITZMARKS capsule in 1 to 2 weeks and repeat X-ray in 5 days to determine the location and extent of elimination of the markers.

Reading the Results (Both Methods)

  1. When over 80% of the markers are passed by day 5, colonic transit is not grossly abnormal.

  2.  When remaining markers are scattered about the colon, condition is most likely hypomotility or colonic inertia.

  3.  When remaining markers are accumulated in the rectum or rectosigmoid, the condition is most likely functional outlet delay, e.g., internal rectal prolapse, anismus.


This product should not be used in patients with known or suspected hypersensitivity to barium sulfate or any component of SITZMARKS.


Ask your healthcare provider if SITZMARKS may interact with any other medicines that you take. Check with your healthcare provider before you start, stop, or change the dose of any medicine. Patients should be evaluated for their ability to swallow the capsule and/or its contents. Make sure each SITZMARKS capsule is consumed with a large glass of water.

Rx only.

Ready for a Closer Look?

If your patient is struggling with chronic constipation, SITZMARKS can help you identify physiological causes and take the next steps toward further testing or a tailored treatment plan. Contact us for more information.

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