[Spastic colon (irritable colon)]

Spastic colon is a pathological entity whose clinical symptoms are for the most part abdominal pain, constipation and episodes of diarrhea without loss of weight. In all probability, it is merely a particularly striking presentation of a GI tract that is irritable throughout its entirety. The pathophysiological basis is a disordered propulsive bowel motoricity. Etiologically, psychological factors in the presence of an appropriate genetic or acquired disposition are conceivable. Possible mediators are considered to be noradrenalin, beta-endorphin and the corticotropin-releasing factor. The diagnosis can be established with a high degree of probability on the basis of the characteristic clinical picture. A definitive diagnosis, however, requires the very careful exclusion of other possible diagnoses. Therapy includes talks with the patient, physical and dietetic measures and the use of drugs to ameliorate diarrhea or, in the case of prokinetic agents, to re-establish normal propulsive bowel activity.