Abstract
Colonic inertia and chronic functional megacolon represent two relatively uncommon disorders of colonic motility. In both disorders, there is evidence of disintegration of the neuroenteric system which governs colonic motor function and in the latter, there is (in addition) atrophy of the collagenous connective tissue which permits exaggerated distension of the colon and thinning of the smooth muscle.
In patients with slow colonic transit, it is important to exclude a defecation disorder which itself may lead to slow transit and which may be reversed with correction of defecation. Most patients with colonic inertia in the absence of a defecation disorder will be considered for subtotal colectomy unless they respond to misoprostol. Sacral nerve stimulation is a potentially effective colon sparing treatment but is not approved for use in the United States. In contrast, most patients with chronic functional megacolon can be managed nonsurgically.
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Wald, A. (2014). Colonic Inertia and Megacolon. In: Rose, MD, MSEd, S. (eds) Constipation. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-0332-0_5
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