Functional Constipation – Slow Transit, Normal Transit, or Defecatory Disorders

Functional Constipation – Slow Transit, Normal Transit, or Defecatory Disorders

Is Your Chronic Constipation Functional???

 Just What Is Considered Chronic Constipation?

I am sure my idea of constipation being chronic, and my doctor’s view would be two different definitions.  I, for one, want to go every day, first thing in the morning and feel like my entire colon has emptied out and the walls of my colon are cleaned as if by a toothbrush.  Sounds gross doesn’t it, but that is the only way I feel like my gut has emptied out and comfortable.

Chronic constipation is more common than most people realize it usually comes with these characteristics of infrequent, painful, and what we feel is incomplete bowel movements.  Like we are not thoroughly cleaned out as I described above.  Actual symptoms of being constipated are supposed to be if you go less than three times in a week, your stools are hard, you must strain, and you are not evacuating entirely and just cannot get the stool to come out.

Patients that have constipation that has become chronic will not have diarrhea due to laxatives.  It is true that chronic constipation in North America will range from 2-28%.  That converts to 63 million individuals who meet all the criteria for Chronic Constipation.  It will increase with age and seems to be more common in females than males.

The different causes of Chronic Constipation are many and varied.

It can run from lesions that structural in your colon like some forms of colon cancer that causes a narrowing in the bowel, thyroid problems, pregnancy, diabetes, Parkinson’s, medications like pain medications (we are talking about narcotics), anti-seizure meds, (Calcium channel blockers) blood pressure medications, drugs taken for muscle spasms.  It is in these cases that sometimes just switching to a different drug may improve your symptoms.

The people in the over 50 age group could be facing a more serious issue/bowel disease, or that structural problem we talked about above could be your start with your constipation, so it is best to see your primary care physician so he or she can rule out any serious issues for you.


If you suffer from chronic constipation that is not caused by “secondary” issues like other medical conditions or any medications you might be taking, you could be suffering from what is called “functional constipation.”  There are three main reasons for functional constipation.  They are slow transit constipation, normal transit constipation, and evacuation or defecatory evacuation disorders.

When you are dealing with normal-transit constipation, you will find the rate of the passage of stool moving through your colon, and your stooling frequency is normal, but you feel like you are constipated.  It could be that if you have changes in the water content of your colon could play a role in the normal transit constipation.

In the slow transit constipation, your movement of stool through your colon is a slower pace than usual.  The defectory problems that can be the cause of your constipation may include dyssynergic pooping; your rectum has prolapsed (this was discussed in an earlier blog; it is when your rectum comes out through your anal opening), an outpouching of your rectum usually called a rectocele.  With a dyssynergia dysfunction, you will often time find it is called pelvic floor dysfunction and sometimes even called anismus, where there is useless coordination of your pelvic floor, rectal, abdominal, and your anal sphincter in the entire evacuation mechanism that has to all work together to make this process follow through to be complete.

Being diagnosed is the first thing that should happen to find out the cause.  Think of it this way:  have you had at least two of these six symptoms in the last three months that fit the criteria of chronic constipation:  hard stools, straining, sensation there is a blockage in your rectal area, you feel like you are not completely emptying your stool when you are done, you are having to use manual means to get the stool out of your body, or having less than three bowel movements in a week?  For this to be true constipation, it will have to occur 25% of the time.

The symptoms that will be your main difference between functional constipation and irritable bowel syndrome will be the abdominal pain which is the primary symptom of Irritable Bowel Symptom.

We must be ever watchful for identification for the “secondary.” reasons for constipation, especially in those patients who have ‘red flag’ warning symptoms when they present to their doctor.  Some of the red flags are:  losing weight without trying, the symptoms started after they were 50 years old, there is blood in their stool, there is a history in their family of colon cancer.

There are diagnostic tests like the colonoscopy that scrutinizes the colon that you may need to give permission to be done.

The “slow transit” constipation will be confirmed in several ways and some specialized studies; one being the sitz marker colon movement test, wireless motility capsule, and radionuclide scintigraphy.  A defecatory disorder can also be confirmed by an anorectal manometry by using a balloon for expulsion or evacuation test or a defecogram.

By now, if you are reading this blog, you are wondering what you can do to improve your constipation problems because if you are like me, they are making you miserable.

If you are one of those that suffer from the issues of constipation, consider high fiber diets and some fiber supplements.  Be sure to increase your fluid intake and by that I mean the good ole H2O.  Exercise helps but may not be the answer to your problem.  Everyone is different.  If yours is a case of dyssynergic defecation, you may need to consider anorectal biofeedback as it may be helpful.  In the cases where it is severe caused by a rectocele or a rectal prolapse, you may need to look at surgery.

My recommendation to you after you have been checked out thoroughly to assure it is not a more serious problem, is to take Colon Cleanse or Super Colon Cleanse on a regular basis.  It is natural, it does not cramp you, and it cleanses your colon and rids you of the toxins in your gut daily.  You will never feel constipated or miserable again.

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