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Functional Disorders: Slow-Transit Constipation.

John Tillou1, Vitaliy Poylin1

  • 1Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts.

Clinics in Colon and Rectal Surgery
|February 2, 2017
PubMed
Summary
This summary is machine-generated.

Slow-transit constipation (STC) is common, with unknown causes but linked to immune changes. Surgery, like subtotal colectomy, may be needed when medical treatments fail for severe STC cases.

Keywords:
colonic inertiaslow-transit constipationsurgical management of constipation

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Area of Science:

  • Gastroenterology
  • Colorectal Surgery
  • Physiology

Background:

  • Constipation is a prevalent gastrointestinal complaint.
  • Slow-transit constipation (STC) represents a significant subset of constipation cases.
  • STC is associated with advanced age, female gender, psychiatric conditions, and a history of sexual abuse.

Purpose of the Study:

  • To review the pathophysiology, diagnosis, and management of slow-transit constipation (STC).
  • To highlight the role of surgical intervention for refractory STC.
  • To discuss the importance of evaluating for concomitant defecatory disorders.

Main Methods:

  • Review of existing literature on STC.
  • Analysis of diagnostic modalities for assessing colonic transit.
  • Evaluation of treatment outcomes for medical and surgical therapies.

Main Results:

  • The etiology of STC is not fully understood but involves immune and cellular alterations.
  • Diagnosis relies on demonstrating slowed colonic transit through various methods.
  • Medical therapies for STC frequently have limited efficacy, necessitating surgical consideration for a minority of patients.

Conclusions:

  • Subtotal colectomy with ileorectal anastomosis is the most established and successful surgical option for STC.
  • Accurate diagnosis and consideration of co-existing defecatory issues are crucial for effective STC management.
  • Further research into STC pathophysiology may yield improved therapeutic strategies.