Digestive Problems
Diseases: Colon and Rectum: Colonic Inertia
Some people suffer from severe constipation because their colon holds on to feces too long. These people suffer from abdominal pain, "gas," abdominal distention, and bloating. They generally do not complain of difficulty emptying their rectum. Instead, they feel as if their intestinal contents never get to their rectum. If there is nothing else found to be the cause of their symptoms, these people may suffer from colonic inertia, a colon that pumps too slowly.
We confirm the diagnosis with a "transit time" measurement that tells us how fast the colon works. We describe this test later. We must also rule out any other cause of slow colon transit such as low thyroid hormone levels. If the colon works too slowly and the person suffers from constipation with abdominal pain and bloating which make daily activities difficult, then surgery may be needed. Surgically shortening the colon corrects a slow colon. Most of the colon is removed, and the small intestine is attached directly to the rectum. This procedure does not require a colostomy (a new opening of the colon onto the abdominal skin requiring a bag).
Colon surgery will relieve constipation due to slow colonic transit in nearly all patients. The surgery will substantially relieve pain in over two-thirds of these patients.
The surgery for slow colon is considered major surgery. It is not quite as dangerous as open heart surgery, chest or brain surgery, but it is major surgery. It is a bigger operation than a hysterectomy. It involves removing about eighty percent of the large intestine. The technical term for the operation is "total abdominal colectomy and ileorectal anastomosis."
Adapted from Dr. Christopher Lahr's book "Shining Light on Constipation."