Severe Constipation and a Slow-Transit Colon: In Plain English «

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Severe Constipation and a Slow-Transit Colon: In Plain English

[Editor's note: This article was originally hosted on MyFamilyDoctorMag.com, our sister site.
It's now featured here as part of our new general-health section.]

by Patricia Raymond, M.D., F.A.C.P., F.A.C.G.

Q. Do you have a solution for a slow, lazy colon? Can your colon actually quit? A doctor told me it could and they would take it out and replace it with a bag! How scary. I’d never heard that and wondered if it is true.

— Sharon, Missouri


A.
Some folks just have a sluggish colon. (We call it prolonged colon-transit time.) And the longer the stool remains in the colon, the more the colon does its job and sucks out fluid from the stool—ergo, the dryer and slower the bowel movements are.

Causes of a Slow Colon

Books adIf your bowel movements have been few and far between all your life, that may be just how you were wired. People like this generally don’t need treatment unless the fullness is uncomfortable or the straining makes veins pop out all over your head. Ditto for occasional constipation.

But it sounds like you may be having severe constipation, which can be a neverending feedback loop. The problem is, as more and more poo presses against your colon, its wall gets stretched thinner and thinner, and the squeeze force you can generate becomes weaker. Thus, your colon keeps getting fuller—and quite packed.

Consider my pantyhose stripped off after a long, hot day—all stretched out with little elasticity or shape. The dilated, floppy look mimics your colon after prolonged constipation.

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Treatment for a Slow Colon

The ultimate solution for this—done rarely—is removal of a portion of the colon, called a subtotal colectomy. This gives the stool less of a length to travel and thus less time to get all dried out and packed in. Although some people have to wear a temporary or permanent colostomy (a bag attached to the intestines through a hole in the abdomen) after the procedure, this is unlikely for someone with your condition.

Before they even consider a colectomy, most people with severe constipation respond to the simultaneous use of several prescription laxatives that work by different mechanisms, such as making the colon squeeze or pulling extra fluid into the bowels. But except for bulk-forming versions like Metamucil, don’t use laxatives (even over-the-counter ones) long-term without a health-care provider’s OK. Certain ones can cause dependency and other side effects.

I also avoid giving fiber until the bowel regimen has been established; when stools aren’t moving, the addition of fiber serves only to increase the bulk of the adobe bricks that are present (straw + “mud” = adobe).

It may take a while to hit on the right combination of meds to establish that perfect bowel pattern. Just try to be patient and work with your gastroenterologist.


Board-certified gastroenterologist
PATRICIA L. RAYMOND, M.D., F.A.C.P., F.A.C.G., practices at Simply Screening in Chesapeake, Va., is assistant professor of clinical internal medicine at Eastern Virginia Medical school and wrote Colonoscopy: It’ll Crack U Up!

Last updated and/or approved: August 2012. Original article appeared in the May 2008 issue of the former print magazine My Family Doctor. Bio current as of that issue. This general health-care information is not meant as individual advice. Please see our disclaimer.

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  • constipated & concerned

    Cut out all processed foods, all gluten, wheat, soy, geneticaly modified organisms found in most foods especially corn (aka GMO), eat 6 very small meals a day at the same time everyday for 2 weeks consisting a veggie (variety of color), & a healthy protein(meats without hormones & antibiotics, raw nuts, eggs, . After 2 weeks slowly introduce fruit & wholegrains (not wheat) read the labels in your food.

    No milk, almond milk is best, but good room temp or hot water (6 to 8 glasses a day), & healthy teas

    If you give me your email, I can scan & send you info that my doctor gave me on all this.

    • Feeling Blessed

      Please send to me too..sandinashley@gmail.com

    • Grateful

      If you could please fwd me information I would be forever grateful. Annien04@gmail.com

    • Vickie5253

      I have been searching for years for answer to this chronic constipation. Any information or diet plan you are willing to share would be much appreciated. email: Vickie5253@aol.com

    • kelly

      Hello! This is the first time I have ever researched this kind of thing and your posting looks most familiar to me. I would love to learn more about how to manage a slow colon naturally with diet. My instincts have told me to avoid Dairy ~ which I try to do but love cheese, especially during the holidays with all the amazing appetizers etc.. Anyway, thanks for your input :) Kelly kbrophy@mcn.org

  • me,too

    Had issues for years and the only thing that worked for me was Magnesium Oxide. Sometimes I do have to take up to 2000mg, but it will work. Take at least 1000mg everynight. Keeps the liquid in the stool.

  • Pingback: How to Stop Excessive Gas: 5 Steps

  • Aisyah Azra

    Hye everyone…I am Azra from Malaysia, 22 years old..have been having this constipation problem for quite some time now..have been depending on laxative..many kind!you name it…I even tried consuming the ancient Chinese remedy called ginseng but it never works..currently taking xenical on daily basis- suggested by the doctor and also have taken praculopride resolor but it initially increases my appetite but eventually it fades away…however can’t bare the headache and dizziness..sigh…I have stopped taking praculopride…have no idea what else to do…my stomach is bloating all the time and I get depress most of the time as I am still very young…taken lots of fiber, fruits, vegetables…but with not much success…not been to the toilet for one month previously…is there any other way or treatment I can undergo to help solve my problem?.=(

    • Shahed

      Yes, I have the same symptom. But now i am almost 99% cure. No medicine.
      Just maintain some health tip & change food that I eat regular. Get help from healyrbody@gmail.com

    • constipated & concerned

      Cut out all processed foods, all gluten, wheat, soy, geneticaly modified organisms found in most foods especially corn (aka GMO), eat 6 very small meals a day at the same time everyday for 2 weeks consisting of veggie (variety of color), & a healthy protein(meats without hormones & antibiotics, raw nuts, eggs, . After 2 weeks slowly introduce fruit & wholegrains (not wheat) read the labels in your food.

      No milk, almond milk is best, but good room temp or hot water (6 to 8 glasses a day), & healthy teas.

  • Ashley

    I thought that this info might help someone. I work in nutrition & some doctors (I believe in Australia) have come up with a diet for IBS/IBD and other bowel disorders. It’s called a FODMAP diet. You can find it on Google or other search engines.

  • moving right along

    Different things work for different people and sadly, we have to find different ways to get things moving. Here is a little secret I have learned, but be warned, I have to attack the problem from the back rather than the front. I use Head and Shoulders Shampoo. Not kidding. When I’m in the bath or shower, I just pour roughly the same amount that you would use on your hair on my finger and Stick it in my butt. It’s not fun (for me at least) but it gets that colon moving almost immediately. You may need to drink a magnesium citrate and get a fresh start. Then if you do the head and shoulders routine EVERY day, it will help keep things moving. Be mindful that from time to time things will probably slow down again, but just reset with the system with the Mag Citrate and start the routine again.

    • Shahed

      this is not the proper way.It may harm your rectum & anus.get help from healyrbody@gmail.com

  • keep hope and faith

    one day i i realised it had been a week since i went to the toilet aand i didnt even feel the need to go.One month later i still hadnt gone to the toilet and i got extremely sick. I went to the Dr but i suffered for months.They used a proceedure where they used soap and water and that cleared out about a quarter. i had that several times and used large amounts of lax.Many tests came back clear even though i have severe dizzyness,head pressure,stomach pain and much much more. ive been severly sick for the last 5-6 years. A specialist odered a test to detect slow transit. after 2 weeks i retained 98% of the dye. But i tried prune juice and when that stopped working i would change to pear juice and keep alternating. It worked better than meds.But what ive learnt is that your bowel gets used to things after a while so you must alternate. Now im still very sick all the time but i go to the toilet every 4 days or so. This is something most people dont know.. that is once your bowels get back into a healthy routine that your bowels can repair themselves to a degree.. so once you flush yourself out completly with a soap and water proceeder or a flushing medication like pico prep. then use the prune and pear juice daily and if you need maybe movical if the juice doesnt work..but please see your Dr first for correct treatment.. but dont give up hope… i used to feel nothing… the Dr said my bowel nerves were ever dead or almost dead… now after forcing my bowels to be regular with juice and medication i have about 70 – 80 % of feeling back in my bowel… i think the sickness is not related and is un diagnosed but i know many previous symptoms were related..So most important is get flushed out, drink prune and pear juice and remember your bowels can repair but it may take along time..in the mean time force your bowels to be regular and seek good medical advice.

    • Shahed

      Yes, I have the same symptom. But now i am almost 99% cure. No medicine. Just maintain some health tip & change food that I eat regular. Get help from healyrbody@gmail.com

    • spencer.strugglin

      Ive been dealing with serious colon problems this past year, many doctor visits and tons of laxitives that i had to quit taking them all together. I now only take stool softners when im in dire need. But the doctors insisted that I dont drink juice!! Because they have so much sugar in them, even the pure juice, all its doing is making my stool more sticky and compacted. Lots of water and exercise. Thats what is making a difference for me. But its a struggle i tell ya.

    • Katie

      What medicine? A laxative? When you do both is it every meal? Or when do you take it? I take a capful of miralax at every meal. Two meals a day only. Body can’t handle three… Even two is hard sometimes but I usually force it

  • John Lemley

    My sluggish colon started after having a colonoscopy. The person doing the procedure said my colon was extra long even though I am a very small built, 117 lbs., 5’6″ man. I suspect my colon was stretched at that time. Transit time is about 7 days. Any ideas? I used to have a glass of hot water upon rising and have a nice BM within a half hour. Another thing, when I am on the phone I have the urge for a BM. How can a phone affect my colon?

  • Robert Boyko

    HI S HOTCHKISS;
    I have Suffered From Severe Constipation for Over 7 Years Now. I have Had Several Lower Back Surgeries. I also Am on my Third Pump Implant for my Back Pain. I Have NO SENSATION TO GO AT ALL. I NEED TO HAVE AN ENEMA EVERY THREE DAYS. I Know how You Feel. I am Starting to Get Depressed Myself. It is just Horrible When You Cannot Go. I Put ALL OF MY TRUST IN OUR LORD JESUS CHRIST. HE WILL NEVER FAIL ME.

    May The GOOD LORD BLESS YOU, INDEED!
    BOB BOYKO

    • Shahed

      Dear friend god always with us.I had the same problem no doctor help me but god.I don’t eat any medicine for normal bowel movement.Now its normal with food & proper exercise.Get suggestion from healyrbody@gmail.com

  • http://Thesurvivaldoctor Vera

    Has anyone had there large intestine removed? And how has there life changed , for better or worse .. Having surgery in 12 days for a rectal prolapse and possibly removing my colon too .. Please, any info will be appreciated..