Redundant colon as a cause of constipation

Abstract

EDITORIAL SYNOPSIS The authors present evidence to show that a long colon is associated with constipation. In certain cases of intractable constipation associated with a long colon they recommend surgical treatment.It is well known that megacolon may cause chronic constipation. On the other hand, the significance in this respect of another anomaly of the colon, namely, a long, or redundant, colon (dolichocolon), is not as clear. The excess length of a redundant colon is usually greatest in the distal colon, the most common variety being an enlarged sigmoid loop (Kantor, 1931). In contradistinction to the megacolon, dilatation of the lengthened portion and thickening of its wall are lacking in the redundant colon.The concept of redundant colon was introduced into the literature by Kantor (1931). He found this anomaly in 343 (18.5 %) of 1,850 patients examined radiologically. The abdominal symptoms, which were more common in the patients with redundant colon than in his series in general, were constipation and distress caused by gas. Constipation was present in 66% of patients with redundant colon and in 46% of the whole series; the incidence of distress due to gas was 70 and 38 % repectively. The incidence of redundant colon was approximately the same as the above in the necropsy series of Bryant (1924), among whose 242 examined subjects a redundant colon was encountered in 14 %. The somewhat higher incidence of 29% was seen in 100 patients with various types of colonic dysfunction reported by Bockus and Willard (1934).There is no reference in the literature to the incidence of redundant colon in patients with constipation as compared with the incidence in persons without this symptom. However, on the basis of the figures reported by Kantor (1931) it can be calculated that 24 % of patients with constipation and 13% of patients without constipation had a redundant colon.For over 25 years, interest in the clinical importance of the redundant colon has been slight. Since the data presented above indicate that it is of some significance as one of the causes of chronic constipation, we have once more studied this question on

Colonic elongation inhibits pellet propulsion and migrating motor complexes in the murine large bowel

“…Compared to normal subjects, patients with severe slow transit constipation (STC) exhibit CMMCs (called propagating pressure sequences) that are reduced in amplitude, propagate more often in an anal to oral direction, and are less coupled between different regions of colon (Dinning et al 2009 b ; 2008). Historically, an elongated colon (called dolichocolon or redundant colon) was believed to be associated with STC (Kantor 1931 a , b ; Brummer et al 1962; Davis 1960; McMahon et al 1999; Dinning et al 2009 a ). ‘The most common related cause of constipation after ARM ( anorectal myectomy ) was a redundant colon’ (Tomita & Howard, 2008).…”

Longitudinal Evaluation of Gray Matter Atrophy in Mild Cognitive Impairment: A Voxel-Based Morphometric Study

“…Kantor, baryumlu kolon grafileri ile yaptığı ilk çalışmalarda 1850 hastanın 343'ünde (%18.5) redundan kolon saptamıştır [3,5].…”

“…Konstipasyon, sindirim sisteminin en yaygın fonksiyon bozukluğudur [22]. Brummer 1962 yılında [3], konstipasyon şikayeti olan hastalarda redundan sigmoid kolonun daha sık görüldüğünü ortaya koymuştur. Raahave ve ark.…”

“…Sigmoid kolon, pelvik girim ile S3 vertebra seviyesi arasında yer alan kolon bölümüdür. Radyolojik olarak redundansi ise, baryumlu kolon grafilerinde sigmoid döngünün iliak krestleri birleştiren çizginin üzerinde yer alması, sigmoid kolonun gerçek pelvisin kranialinde izlenmesi olarak tanımlanmıştır [1][2][3].…”

Painful constipation: a neglected entity?

“…Although in older studies a redundant colon was associated with marked constipation, pain and gas (31), it is presently thought that colonic length does not represent a significant factor in constipation (32). Further studies are needed to explore this association.…”