Slow Transit Constipation

Constipation is by far the most common gastrointestinal problem which affects both men and women and can lead to serious psychosocial and physical issues. As per an epidemiology study of constipation, 16% women and 12% women out of the 10,018 surveyed people met constipation criteria. Constipation is divided into many categories like obstructed defecation, normal transit constipation and slow transit constipation. Constipation is the reason for around 92,000 hospital admissions and 2.5 million doctor visits in the US each year.

Slow Transit Constipation: What Is It?

Increased opposition to the emission of contents present in the colon and inadequate colonic propulsion are some of the causes of a clinical syndrome known as STC. This term was coined for young women having very slow total gut emission. STC patients have difficulty in passing out stool but have no identifiable cause to explain their symptoms. Referred to as ‘functional’ this kind of constipation is found in 15 to 30 percent of constipation patients. STC is idiopathic and chronic, can occur at any stage of life and is more prevalent in young women than men. It might develop after childbirth or undergoing a hysterectomy.

Symptoms of Slow Transit Constipation

The common symptoms are:

  • Appetite loss
  • Nausea
  • Abdominal pain
  • Uncontrollable soiling
  • Constipation
  • Infrequent bowel movements

Rare symptoms of STC are:

  • Hemorrhoids
  • Bloody stools
  • Diarrhea

How to Diagnose Slow Transit Constipation

The standard tests utilized for diagnosing constipation make it hard for doctors to diagnose STC. These tests include:

  • X-ray – to check if the excess feces have distended the bowel.
  • Barium enema – taking x-rays after flushing a special contrasting liquid into the bowel through the anus.

An STC diagnoses can be confirmed by making use of one or more of the following diagnostic measures:

  • A full workup by a specialist continence adviser– children suffering from STC might have an extremely swollen abdomen and experience a lot of pain.
  • Colonic nuclear transit study (NTS) – a radioactive dose is given to the child. The dose is then tracked for three days as it passes through the child’s bowels.
  • Full thickness laparoscopic biopsy – incisions are made on the abdomen in three different places and bowel wall samples are taken out for examination of messenger molecules, nerve supply and muscles. This biopsy is not to be confused with rectal biopsy.

Treatment for Slow Transit Constipation

Medications and Therapies

There is no complete cure, however, there are options for you to ease the symptoms such as:

  • Taking medicines for improving your bowel movements.
  • Making use of enemas on a regular basis to flush out the feces from the rectum.
  • Interferential electrical stimulation therapy, the treatment method used in the TIC TOC trial. It is a simple and painless treatment option which can increase the bowel movements of children and also improve their ability to empty their bowel without the use of surgery, washouts or medicines.

Surgery for Slow Transit Constipation

Surgical intervention becomes necessary for some people whose symptoms are of a severe nature and can’t be controlled by medication. The age and overall health of children as well as the affected bowel’s location and extent will decide which type of surgery is selected. The surgical options available are:

Colostomy is one of the surgeries that can be performed in which an artificial hole is created in the abdominal wall to reroute the bowel, accompanied with the fitting of a colostomy bag. Temporary colostomy is also among the available options.

Creation of a tiny opening or stoma is also one of the surgical options in which the appendix can be brought up to the surface. A laparoscope can be used for performing this procedure. Regular enemas can be given directly into the appendix or the stoma.

If the bowel is extensively damaged, then the treatment of STC with surgery might not remain an option.

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