Colon motility (manometric) study, minimum 6 hours continuous recording (including provocation tests, eg, meal, intracolonic balloon distension, pharmacologic agents, if performed), with interpretation and report
CPT4 code
Name of the Procedure:
Colon Motility Study, Colon Manometry
Summary
A colon motility study, also known as colon manometry, is a diagnostic test used to assess the muscle activity in the colon. It involves continuous recording of the colon's movements over at least six hours, often including various provocation tests like eating a meal or applying an intracolonic balloon. This data helps physicians understand how well the colon is functioning.
Purpose
The procedure is designed to identify abnormal colonic movements that may contribute to conditions like chronic constipation, irritable bowel syndrome, or other motility disorders. The goal is to diagnose issues with colon motility and guide appropriate treatment strategies.
Indications
This study is indicated for patients experiencing:
- Chronic constipation
- Unexplained abdominal pain
- Suspected colonic motility disorders
- Irregular bowel movements
The procedure is particularly appropriate for patients who have not responded to conventional treatments for these conditions.
Preparation
Patients are typically instructed to:
- Fast for at least 8 hours before the test.
- Adjust or discontinue certain medications as advised by their healthcare provider.
- Undergo a bowel cleansing regimen to ensure the colon is empty.
Pre-procedure assessments may include a review of medical history and physical examinations.
Procedure Description
- Insertion of Catheter: A thin, flexible catheter with multiple pressure sensors is gently inserted through the rectum into the colon.
- Initial Recording: Baseline motility recordings are taken for a period.
- Provocation Tests: Various stimuli such as a meal, balloon distension, or pharmacologic agents may be introduced to observe changes in colon motility.
- Continuous Monitoring: The catheter records motor activity in the colon continuously for a minimum of six hours.
- Data Analysis: The recorded data is analyzed to understand muscle activity patterns.
Specialized equipment includes manometry catheters and recording devices. Anesthesia is not usually required, but mild sedation may be used for patient comfort.
Duration
The procedure typically lasts at least six hours, including preparation and provocation tests.
Setting
Colon motility studies are generally performed in a hospital or outpatient clinic equipped with the necessary monitoring technology.
Personnel
- Gastroenterologist
- Registered Nurse
- Technician specializing in manometry
Risks and Complications
Common risks include discomfort during catheter insertion, mild cramping, or bloating. Rare complications may involve rectal bleeding or infection, manageable with appropriate medical care.
Benefits
This test provides detailed insights into colon muscle function, guiding the appropriate treatment for motility disorders. Results are usually available within a few days, leading to improved targeted therapies.
Recovery
- Patients can typically resume normal activities right after the procedure.
- Instructions may be given regarding diet or medications post-procedure.
- Follow-up appointments may be scheduled to discuss results and further treatment.
Alternatives
- SmartPill motility testing
- Radiopaque marker study
- Barium enema
These alternatives have different benefits and limitations, such as varying levels of invasiveness and diagnostic specificity.
Patient Experience
Patients might feel some discomfort during catheter insertion and slight cramping throughout the test. Pain management strategies, including mild sedation, are available to enhance comfort. After the test, most patients feel normal and can go home the same day.