About Sitzmarks Diagnostic Test

What are Sitzmarks?

SITZMARKS is a colonic transit diagnostic test. This transit time test helps physicians select the best therapeutic option for adult patients with severe constipation who have otherwise negative GI evaluations. Sometimes called “sitz markers,” the Sitzmarks test can help physicians diagnose hypomotility, colonic inertia and functional outlet obstruction.

Sitzmarks are Barium Sulphate impregnated PVC O-rings in convenient gelatin capsules. The patient swallows the capsules and the rings are monitored by X-ray to observe gastrointestinal motility. Once ingested, the O rings are released and travel the gastrointestinal tract. X-rays at specific times can help diagnosis conditions such as hypomotility, bowel obstruction or outlet delay. SITZMARKS are available in three different lumens. They may be ordered directly from Konsyl Pharmaceuticals.

• Convenient gelatin capsules
• Efficient pre-cut radiopaque rings
• Time-saving and cost effective
• 10 capsules per package; Each capsule contains 24 Radiopaque polyvinyl chloride markers of 1 mm X 4.5 mm
• Can help avoid surgery
• Alternative to barium enema

How have Sitzmarks been used?

• Indication: Adult patients with severe constipation but otherwise negative GI evaluations.
• SITZMARKS are to be dispensed only by physicians to patients for oral intake.
• Sitzmarkers have been used in colon-transit studies to diagnose Irritable Bowel Syndrome (IBS), chronic constipation, bowel disorders, pelvic floor dysfunction and slow motility.
• The SITZMARKS radiopaque markers can be used to conduct either a simple test using one capsule and X-raying on day five, or a segmental test in which the patient takes one capsule each day for three days, with X-rays taken on day four and day seven.
• A few of the studies that have used Sitzmarks:
  • http://www.agacmecafe.com/modules/kci/takeda/transcript.asp
  • “Chronic Constipation: Diagnosis and Treatment,” Endoscopy Review, November/December 1987, Ogorek, C.P., Reynolds, J.C.
  • “Chronic Constipation,” Postgraduate Advances in Colorectal Surgery, 1989, 1(12):1-22, Wexner, S.D. Jagelman, D.G.
  • “Streamlining the Management of Defecation Disorders,” Diseases of the Colon & Rectum, September 1990, Berman, I.R., et al.
  • “Colectomy for Constipation: Physiologic Investigation is the Key to Success,” Diseases of the Colon & Rectum, 1991 34:851-6, Wexner, S.D., Daniel, N., Jagelman, D.G.
  • “Outpatient Protocol for Biofeedback Therapy of Pelvic Floor Outlet Obstruction,” Diseases of the Colon & Rectum, January 1992, Fleshman, J.W., et al.
  • “What is the Meaning of Colorectal Transit Time Measurement,” Diseases of the Colon & Rectum, August 1992, Bouchoucha, M., Devroede, G., et al.

Frequently Asked Questions about Sitzmarks GI markers

What are Sitzmarks made of?

Each gelatin capsule which dissolves in the stomach contains 24 radiopaque markers (polyvinyl chloride with barium sulphate embedded). They pass through the digestive tract just as food and waste do. They will be expelled in the same condition as they were ingested. No barium or plastic is absorbed into the patient's system. There is no harm in the markers being in the body for several days.

Are Sitzmarks safe to take during pregnancy?

Sitzmarks themselves are safe to preganant women; however, the X-rays required to determine the location should be discussed. Any pregnant woman should always inform her physician that she is or could be pregnant when ingesting any medicine or device. The physician may want to delay the test until after the end of the pregnancy.

Are Sitzmarks available as samples?

No. Sitzmarks are a one-time use marker and are sold in a box of 10 capsules to physicians, radiology centers and hospitals.

What determines the choice between simple and segmental use?

See this page for complete information on how to use Sitzmarks. If the physician simply wants to detect a blockage or colonic inertia in a chronically constipated patient, he would use the simple method -- 1 capsule and an X-ray in 5 days. If the physician wants to track the amount of time that it takes to pass through each section of the intestinal tract, she would use the segmental method -- 1 marker ingested for 3 consecutive days and then multiple X-rays to count and track 24 hour intervals.

Why do the Sitzmarks have an expiration date?

The product has an expiration date because we have tested and documented that the packaging components (foil and PVC blister) and the gelatin capsules are within specifications at the end of the product shelf life (4 years from manufacture).

How do I code a Sitzmarks test?

See this page for advice on CPT codes for Sitzmarks.