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Related Experiment Videos

Slow-transit Constipation.

Adil E. Bharucha1, Sidney F. Philips

  • 1Gastroenterology Research Unit and Enteric Neurosciences Program, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA.

Current Treatment Options in Gastroenterology
|July 27, 2001
PubMed
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Treatment of Severe and Intractable Constipation.

Current treatment options in gastroenterologyยท2004
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Idiopathic slow-transit constipation, a condition causing severe constipation due to disordered colonic motor function, primarily affects women. Treatment options range from medications to surgery for refractory cases.

Area of Science:

  • Gastroenterology
  • Colorectal Surgery

Background:

  • Idiopathic slow-transit constipation (STC) is a functional gastrointestinal disorder.
  • It is characterized by intractable constipation and significantly delayed colonic transit.
  • STC is predominantly diagnosed in women and linked to impaired colonic motor function.

Purpose of the Study:

  • To define the clinical spectrum of idiopathic slow-transit constipation.
  • To outline diagnostic criteria and differential diagnoses for STC.
  • To review current and surgical treatment options for STC.

Main Methods:

  • Diagnosis involves excluding other causes of constipation, such as obstruction, metabolic disorders, and pelvic floor dysfunction.
  • Pharmacologic management includes fiber, osmotic laxatives, and stimulant laxatives.

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  • Surgical intervention, specifically subtotal colectomy, is considered for severe, medically refractory cases.

    • Main Results:

    • STC presents a spectrum of severity, from mild transit delays to colonic inertia and chronic megacolon.
    • Medical management is the first-line approach for most patients.
    • Subtotal colectomy offers an effective treatment for selected patients with severe STC.

    Conclusions:

    • Idiopathic slow-transit constipation is a complex condition requiring thorough evaluation.
    • A stepwise approach to treatment, from conservative measures to surgery, is often necessary.
    • Surgical consideration for STC is warranted in refractory cases after excluding or treating pelvic floor dysfunction.