fast transit??

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I recently had a pillcam endoscopy, which found i had a very fast transit. the camera pil was in & out of my entire digestive system in 4hrs.  ( i have chronic diarrea & abdo pain everyday, most of the day). i also have colitis, bile acid malabsorption (both controlled with meds) fructose malabsorption & ibs-d (both controlled with amended diet in sync with specialist dietician).

Does anyone know what can actually be the cause of fast transit? recent colonoscopy was normal too.

0 likes, 7 replies

7 Replies

  • Posted

    Looloo! Hello,

    Didn't see your experience earlier.

    You could give us something of your speed! ;-)

    BTW did you get the pill camera due to pain or due to obvious or occult blood found?

    (I asked for my abdominal pain struggling daughter and I was told 'it is a very expensive diagnostic tool. It is only done when blood occurence in stool was unexplainable'. ??)

    So your swallowed pill camera appeared only 4 hours later?

    or it passed the small intestine into the large intestine in 4 hours and 'came out' later?

    Including colon, wow, would be Speedy Gonzales.

    Yes, that can lead to absorbtion, digestion problems.

    Your thyroid is checked?

    As usual stress/anxiety makes transit fast, is one more nervous when swallowing a pill camera? I don't know, I don't think so.

    The bile acid malabsorption is really well controlled so that cannot be the cause for fast transit/diarrhea?  (bile acid binders)

    Really running out of explanation models, what do docs say?

    Could gastrin and prostaglandin be checked? (both cause diarrhea if high, gastrin has to be stimulated I think, blood 2 times taken)

    The newer approach of autoimmune antibodies causing GI dysmotility including diarrhea/rapid transit (AGID)

    are evidence of neuronal Kv4.2 potassium channel antibodies (dipeptidyl-peptidase-like protein-6 (DPPX),

    they are known to cause hypermobility, but I am sure if not being in the US at a Mayo clinic one cannot test for them. Also hard to tackle, what to do then if positive.?

    How are you going right now?


    • Posted

      Hi Sanya! Thankyou for responding. yes my gastro consultant said the camera pill was in & out in 4hrs -he could tell this as the data recorder loses contact when it leaves the colon, so yes it was fast! it was no problem with the pill; i am very used to having to swallow large pills due to my meds, so i wasn't at all nervous, just swallowed it with a little water, got strapped up by the consultant & that was it.

      my thyroid has recently been checked & it was fine.

      my gastro consultant has run out of explanations/possibilities too, which is why HE has referred me for a 2nd opinion at another hospital with a colleague consultant. he said sometimes a fresh pair of eyes on things can help, & he's not so precious he might not have missed something. at least he is humble enough to do this.

      i am due to see the 2nd opinion doc in early december. do you think i should ask about what you said in your last few para's about gastrin, prostaglandins, & did you mean hypermotility in your last para?

      I am hoping to go back to work for a few hours middle of next week as the amitryptiline & buscopan combined appear to be slowing my bowels down & thus reducing the pain as i am not going so many times in a day(which always makes the abdo pain worse) i think the only thing the buscopan appear to be doing, is reducing the urgency when i do need to go, & help to relieve a bit the feeling of pressure in my abdo even though they don't visibly reduce my bloated abdo. i think the amit. are doing more for the pain & actually slowing my bowels down(a side effect of ami is constipation, but I'm not suffering that - just being slowed down).

      so as it stands no further diagnosis on top of what i already have, but the "band aid"meds are helping me for now & i see the other consultant in december.


    • Posted

      Oh my sad, tired brain.

      'Hypermotility' of course. redface

      Once the second opinion doc is through with his second opinion and no 'hormonal' testing was offered, I would ask sublte as possible, what he thought about hormones like gastrin and prostaglandin to check.

      The latter idea about hypermotility from the Mayo study with the autoimmune disease connection and very rare antibody tests, you might want to mention, but I was e.g. here in Australia dismissed to be a reason (can cause constipation as well) and anyway not available testing, only ANA and ENA is done (as if that was all that existed).

      Very interested in Ami side effect, since my daughter get's 75mg per day. Constipation in ascending colon (only there, no where else, due to connective tissue failure it seems) has always been an issue prior medication, so getting those medications and 'constipation' not mentioned as a side effect, is almost neglect. (docs only mention constipation as a problem with narcotics, hence she only get's on special holidays like birthday a dose for pain relief with load of Movicol)

      You have a beautiful doc if he is so open not just to give up and I have tested it all, but to say, have someone else I recommend look at you in case I overlooked something to think of.

      Thumbs up!!!

      All the best!!

      And yes, wow, 4 hours even including colon passage is massively fast.

      Take care, Speedy Gonzales!


    • Posted

      Hi Sanya. speedy gonzalez here!!!

      Thankyou for your reply, i have noted gastrin, prostaglandin & autoimmune antibodies to ask about on my appt letter for thursday.

      i am still doing well on the 20mg ami & 6-8 buscopan a day. i think the ami is doing more work than the buscopan with regards to better pain relief, but i think the buscopan are assisting the ami with slowing motility a bit, & relieving the discomfort a bit of feeling bloated even though i still am bloated. i have gynae issues too now, so that may also be contributing to the bloating. (no weight gain either).

      i looked up in the patient info leaflet of the ami, & under side effects of brain & nervous system it says they can cause constipation.

      also, i had to have an occ health med assessment last week & the doctor i saw was fab. i asked him if the ami & buscopan would continue working for me (ie not get less effective with time) & he said particularly the ami is very good for people with ibs & ibd in terms of pain relief & slowing down motility. both buscopan & ami are anti-cholinergic drugs - i asked him what this means; he said anti cholinergic work on the para-sympathetic side of the brain which slows  things down in the body (the sympathetic side speeds things up) which is why i suppose in combination they are working to slow my bowels down (& not producing constipation in my case, just making my bowels more "normal"wink. i found him very helpful, & interesting, i like to know why/how things work.

      my consultant has only got more thorough with me because i have had to point things out to him & push for diagnosis rather than leaving me in limbo for months at a time.  obviously i would prefer a pinpoint diagnosis to treat my symptoms rather than mask them with band aid meds, but at least nothing serious has been found.

      hope the info about the ami helps Sanya. i wonder if a "cholinergic" drug would help your daughter (cholinergic works on the sympathetic side of brain that speeds things up)???........

      take care,

      kind regards,


    • Posted


      Wow, your doc wrote those possible check parameters on the appt letter?

      How great!

      So funny, I asked GI doc 2 weeks ago about 75mg Ami and he said 'no, no, there is no constipation impact'. Duh.

      My daughter suffers already facial flushes, sweaty hands and tachycardia episodes (hence has to do parasympaticus/vagus manouvres) and intense abdominal cramping in 15-30sec intervalls (despite Ami); when given meds for gastroparesis (should speed things up) they didn't have any impact.

      Uagh, intestine is so complex, isn't it.


    • Posted

      Hi Sanya,

      I must correct what i said about parasympathetic & sympathetic; they are 2 sides to the autonomic central nervous system which is part of the brain.

      It is me that has noted on my appt letter for tomorrow(to ask consultant about) about the gastrin & prostaglandin following your suggestions recently to me!

      If you look at the patient info leaflet in a box of ami under side effects, then under brain/nervous system, it does list constipation.

      what are parasympaticus/vagus manouvres?  i was reading for a while on wiki last night, & it says alot about the link between brain, CNS, ANS links to many gut problems.......

      You're right it is complex!!!

    • Posted


      I did this once too on referrals

      or when notes are clearly wrong

      (e.g. when written 'endometriosis is excluded' and actually only 'endometrioma' was excluded via MRI (ovary look, no endometriosis look). It's a huge difference! 

      For her (and me) face dipped into ice cold water helps against sudden onset of fast heart rates (that's one of vagal maneuver - sorry, it's called vagal maneuver, not vagus manouver. No wonder you couldn't find it, blush.), and drinking cold water. (diving reflex).

      Her intestine is very slow though, so it doesn't quite link together.

      Yes, complex, complex, complex.

      All the best!!!


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