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Chronic idiopathic slow transit constipation: pathophysiology and management.

M El-Salhy1

  • 1Section for Gastroenterology and Hepatology, Department of Medicine, Institute of Public Health and Clinical Medicine, University Hospital, Umeå, Sweden. magdy.el-salhy@medicin.umu.se

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
|June 20, 2003
PubMed
Summary

Idiopathic slow-transit constipation patients can be divided into two groups. One group may benefit from surgery, while the other is better treated with medication.

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Area of Science:

  • Gastroenterology
  • Colorectal Surgery

Background:

  • Idiopathic slow-transit constipation (STC) is a rare condition affecting a small subset of patients with constipation.
  • Understanding the pathophysiology of STC is crucial for effective clinical management.

Purpose of the Study:

  • To provide an updated review of the pathophysiology of idiopathic slow-transit constipation.
  • To discuss the clinical management strategies based on the underlying pathophysiology.

Main Methods:

  • A comprehensive literature search was conducted using Medline.
  • English language articles published up to September 2002 concerning slow-transit constipation were reviewed.

Main Results:

  • Patients with idiopathic STC were categorized into two distinct subgroups based on gastrointestinal motility.

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  • Subgroup 1: Normal proximal gastrointestinal motility, constipation linked to childbirth or pelvic surgery.
  • Subgroup 2: Dysfunctional enteric nervous/neuroendocrine system, generalized gastrointestinal dysmotility.

    • Conclusions:

    • Surgical treatment may be beneficial for subgroup 1 patients.
    • Medical management is generally more effective for subgroup 2 patients due to generalized gastrointestinal dysmotility.