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Slow-transit constipation

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Opinion statement

  • Idiopathic slow-transit constipation is a clinical syndrome predominantly affecting women, characterized by intractable constipation and delayed colonic transit. This syndrome is attributed to disordered colonic motor function.

  • The disorder spans a spectrum of variable severity, ranging from patients who have relatively mild delays in transit but are otherwise indistinguishable from irritable bowel syndrome to patients with colonic inertia or chronic megacolon.

  • The diagnosis is made after excluding colonic obstruction, metabolic disorders (hypothyroidism, hypercalcemia), drug-induced constipation, and pelvic floor dysfunction (as discussed by Wald [1]).

  • Most patients are treated with one or more pharmacologic agents, including dietary fiber supplementation, saline laxatives (milk of magnesia), osmotic agents (lactulose, sorbitol, and polyethylene glycol 3350), and stimulant laxatives (bisacodyl and glycerol).

  • A subtotal colectomy is effective and occasionally is indicated for patients with medically refractory, severe slow-transit constipation, provided pelvic floor dysfunction has been excluded or treated.

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Authors and Affiliations

  1. Gastroenterology Research Unit and Enteric Neurosciences Program, Mayo Clinic, 200 First Street, SW, 55905, Rochester, MN, USA

    Adil E. Bharucha MD & Sidney F. Philips MD

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  1. Adil E. Bharucha MD
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  2. Sidney F. Philips MD
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Bharucha, A.E., Philips, S.F. Slow-transit constipation. Curr Treat Options Gastro 4, 309–315 (2001). https://doi.org/10.1007/s11938-001-0056-9

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  • DOI: https://doi.org/10.1007/s11938-001-0056-9

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