title: Functional Disorders: Slow-Transit Constipation.
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.
authors.affiliation: Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: John
authors.initials: J
authors.lastname: Tillou
authors.affiliation: Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Vitaliy
authors.initials: V
authors.lastname: Poylin
keywords: colonic inertia; slow-transit constipation; surgical management of constipation