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Length of the Adult Human Colon in Health and Constipation Measured Using Magnetic Resonance Imaging
Faiz Alqarni1,2,3, Soma Kumasaka4,5, Caroline L Hoad2,6
1Translational Medical Sciences, Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham, UK.
Neurogastroenterology and Motility
|December 2, 2025
Summary
Adults with chronic constipation (CC) have significantly longer colons than healthy volunteers. Their colons also show a reduced ability to elongate longitudinally after a laxative challenge, unlike healthy individuals.
Area of Science:
- Gastroenterology
- Medical Imaging
- Human Physiology
Background:
- Quantitative data on colon length in adult chronic constipation (CC) are lacking.
- This study aimed to measure colon length in CC patients compared to healthy volunteers (HV) and patients with irritable bowel syndrome with constipation (IBS-C).
Purpose of the Study:
- To measure colon length in CC patients and compare it to HV and IBS-C patients.
- To assess colon elongation capacity in response to an osmotic laxative challenge using MRI.
Main Methods:
- Manual tracing of segmental and total colon length on MRI scans from 57 HV, 17 CC, and 9 IBS-C patients.
- MRI scans were performed in a fasting state and after an oral osmotic laxative challenge in CC patients and some HV.
Main Results:
- CC patients exhibited significantly longer colons (162 cm) than HV (127 cm).
- The colon in HV elongated significantly (133 cm to 148 cm) after the laxative challenge, while the CC colon showed no significant elongation (162 cm to 168 cm).
- Colon length in IBS-C patients was similar to HV.
Conclusions:
- CC is associated with increased colon length and a reduced capacity for longitudinal elongation in response to laxatives.
- Colon length in IBS-C patients is comparable to that of HV.
- These findings enhance understanding of gut disease pathophysiology and treatment response.
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