Hinton test

The Hinton Test was developed in 1927 by William Augustus Hinton (1883 - 1959) (Grimes 2013).

The Hinton test is used to objectify constipation (Herold 2020). It is an imaging procedure used in gastroenterological functional diagnostics to determine the colonic transit time (Antwerpes 2023).

The Hinton test should not be confused with the "Hinton test", a test used in Anglo-American countries to diagnose syphilis(Grimes 2013).

Indications:

• Chronic constipation
• Surgery and therapy follow-up
• Follow-up
• Clarification of
  • Fecal incontinence
  • Defecation disorders (Antwerpes 2023)

Procedure:

First of all, an oral intake of radiopaque markers (Herold 2020) is performed for 6 days (Antwerpes 2023); this usually involves a capsule with 10 opaque markers (Heilmann 2019). On day 7, an overview image of the abdomen is taken in a lying and standing position (Antwerpes 2023).

According to the guideline, a stool log should be kept parallel to the entire test phase (Andresen 2022).

Evaluation:

The abdomen is divided into 3 regions:

- right hemicolon

- left hemicolon

- rectosigmoid (Antwerpes 2023).

First, the number of markers present is determined. The total transit time and partial transit time in the individual sections are then determined (Antwerpes 2023). The sum of the markers x 2.4 gives the colonic transit time. This averages 30 - 40 hours in total, approx. 11.3 hours in the right hemicolon and approx. 12.4 hours in the rectosigmoid (Heilmann 2019).

Interpretation:

The passage time in hours can be calculated from the number of markers. The normal value for women is ≤ 70 hours, for men ≤ 60 hours.

The test is considered pathological if > 20 % of the previously administered markers remain in the colon. Depending on the localization of the distribution, a distinction can also be made between:

- Hypomotility

In this case, the markers are distributed throughout the colon.

- Anorectal obstruction

In this case, the markers are distributed in the left hemicolon and rectosigmoid (Antwerpes 2023).

1. Andresen V, Becker G, Frieling T, Goebel- Stengel M, Gundling F, Herold A, Karaus M, Keller J, Kim M, Klose P, Krammer H, Kreis M E, Kuhlbusch- Zicklam R, Langhorst J, Layer P, Lenzen- Großimlinghaus R, Madisch A, Mönnikes H, Müller- Lissner S, Rubin D, Schermann M, Schwille- Kluntke J, Stengel A, Storr M, van der Voort, Voderholzer W, Wedel T, Wirz S, Witzigmann H, Pehl C (2022) Updated S2k guideline chronic constipation of the German Society for Gastroenterology, Digestive and Metabolic Diseases (DGVS) and the German Society for Neurogastroenterology and Motility (DGNM). AWMF registration number: 021 - 019
2. Antwerpes F, Nolte J, Fink B, Ostendorf N, Sylmetaj J (2023) Hinton test. DocCheck Flexikon DOI: https://flexikon.doccheck.com/en/Hinton-Test#:~:text=The%20Hinton%2DTest%20is%20a,%C3%BCabout%20the%20transport%20function%20of%20the%20intestine.
3. Grimes J A, Apffel Smith L, Fagerberg K (2013) Sexually Transmitted Disease: An Encyclopedia of Diseases, Prevention, Treatment, and Issues. Greenwood Publishing 317
4. Heilmann K, Gingert C, Hetzer F (2019) Chronic constipation In: Manual of Colonic Proctology by A. Herold and T Schiedeck. Volume 2, 31 - 50
5. Herold G et al (2020) Internal medicine. Herold publishing house 461
6. Kasper D L, Fauci A S, Hauser S L, Longo D L, Jameson J L, Loscalzo J et al. (2015) Harrison's Principles of Internal Medicine. Mc Graw Hill Education