[Colonic inertia and rectal obstruction (Arbuthnot Lane disease)]

Colonic inertia and outlet obstruction are a major problem of constipation affecting almost solely women and are characterised by an extreme slowness of colonic transit time (less than 80 percent of the markers eliminated in five days) and by a lack of relaxation and a contraction of pelvic muscles, mainly of the pubo-rectalis, during defecation. This syndrome is associated with a high frequency of gynecological diseases (first described in 1908 by Arbuthnot Lane), galactorrhea, urological abnormalities, abnormal manometric oesophageal recordings, Raynaud's phenomenon, idiopathic oedema, orthostatic hypotension and neurological symptoms. A distinctive abnormality of the colonic myenteric plexus has been described. Medical treatment of the affection is without effect, with the exception, perhaps, of the prescription of naloxone. In the absence of other therapeutic means, subtotal colectomy with ileo-rectal and coeco-rectal anastomosis may give relative improvement.