Abstract
Constipation is a very common complaint, with slow-transit constipation (STC) accounting
for a significant proportion of cases. Old age, female gender, psychiatric illness,
and history of sexual abuse are all associated with STC. The exact cause of STC remains
elusive; however, multiple immune and cellular changes have been demonstrated. Diagnosis
requires evidence of slowed colonic transit which may be achieved via numerous modalities.
While a variety of medical therapies exist, these are often met with limited success
and a minority of patients ultimately require operative intervention. When evaluating
a patient with STC, it is important to determine the presence of concomitant obstructed
defecation or other forms of enteric dysmotility, as this may affect treatment decisions.
Although a variety of surgical procedures have been reported, subtotal colectomy with
ileorectal anastomosis is the most commonly performed and well-studied procedure,
with the best track record of success.
Keywords
slow-transit constipation - colonic inertia - surgical management of constipation
