Colonic Dysmotility
 
Colonic dysmotility refers to chronic constipation.  The colon has the job of absorbing all the fluid and electrolytes that were poured into the gut for digestion of nutrients.  Bacteria coexist within the colon and process the residue of the diet, which is mostly dietary fiber. Once the colon is done with absorption of fluid and fermentation of fiber, what’s left inside the colon becomes more solid.  The colon moves stool by rhythmic contractions of short segments.  For these contractions to be effective there has to be an intact autonomic nervous system and muscle layer in the bowel.  
 
When contractions are not effective, stool cannot be expelled.  Various conditions affect this process; for instance, gymnasts can develop compression of their nerve roots from the repeated strenuous landings they make and that can result in the loss of contractions.  Pregnancies of large babies, complicated labor and delivery can also affect the nerves supplying the colon and rectum.   
 
There are many ways of dealing with this problem, including dietary adjustments, laxatives, and enemas.  When these measures no longer work, surgery becomes an option.  Before proceeding with surgery we perform typical studies such as the colonic transit time study by Sitz Marks.  This study involves ingesting tracers that can be followed and counted through plain radiographs.  If medical therapy has failed and studies like the Sitz Marks confirm a colonic dysmotility then surgery is indicated.

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