Indication/Directions for Use

INDICATION: Adult patients with severe constipation but otherwise negative GI evaluations.  SITZMARKS® capsule is to be dispensed only by physicians to patients for oral intake. 

  

SIMPLIFIED SITZMARKS® METHOD (1 capsule: each capsule with 24 markers)

Use the Simplified SITZMARKS® Method to detect a blockage or colonic inertia in a chronically 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 follow-up abdominal X-rays 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: If more than 6 markers are still retained at 5 days

  1. Have patient take a bulking agent (such as KONSYL® Original) 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-rays in 5 days to determine the location and extent of elimination of the markers.

 Click here for instructions on how to interpret a SITZMARKS® test

SEGMENTAL (METCALF) SITZMARKS® METHOD (3 capsules: each capsule with 24 markers or 3 capsules: each capsule with 24 markers-available in 3 different shapes)

Use the Segmental Method to track the amount of time that it takes to pass through each section of the intestinal tract.
 
Take the O-ring marker on day 1; the Double D marker on day 2, and the Tri-Chamber marker on day 3.

  1. On day 1, day 2, and day 3, administer one SITZMARKS® capsule by mouth with water, preferably with confirmation by office observation. Instruct patient to use no laxatives, enemas or suppositories for the duration of the test.
  2. Arrange a flat plate abdominal X-ray on day 4 and, if necessary, again on day 7 to determine the location and extent of elimination of the radiopaque markers.
  3. The total number of markers in each segment is used to determine transit time regardless of the type.

    EXAMPLE: Total number of markers present in each segment will be equivalent to the transit time in hours
     
 

Right Colon 

Left Colon

Rectosigmoid

Colon 

TOTAL 

4th Day

12

14 

14

40

 

7th Day

0

0

2

2

 

Transit Time

12 hours

14 hours 

16 hours

42 hours 

 

Normal Value

11.3 hours 

11.3 hours 

12.4 hours

 

35 hours

  1. On day 4, if there are more than 50 markers, transit time is abnormal and an X-ray needs to be taken on day 7.
  2. If total colonic transit time is > 70 hours, then transit in any segment is abnormal if > 30 hours. (> = more than).