Our Summary

This research paper looks into the impact of problems with the upper part of the digestive system (called upper gastrointestinal or UGI dysmotility) on the outcomes of surgical treatment for colonic inertia (CI), a condition where the colon does not work properly to push stool out of the body. The study reviewed a number of previous studies and found that a significant proportion of patients with CI also had issues with the movement of their upper digestive system. These patients were more likely to continue having constipation after their surgery and less likely to see improvements in their quality of life compared to those without these issues. However, the presence of UGI problems did not affect the likelihood of complications from surgery or issues with bowel control. The researchers suggest that many people with CI may also have undiagnosed issues with their upper digestive system, which could be linked to a higher risk of continued constipation and less improvement in quality of life after surgery. They recommend that doctors should routinely check for UGI issues before conducting surgery for CI.

FAQs

  1. What is the connection between upper gastrointestinal (UGI) dysmotility and colonic inertia (CI)?
  2. How does the presence of UGI issues impact the outcomes of surgical treatment for CI?
  3. Why do the researchers recommend doctors to check for UGI issues before conducting surgery for CI?

Doctor’s Tip

A doctor might advise a patient undergoing colectomy to discuss any potential issues with their upper digestive system (UGI dysmotility) before the surgery. This can help determine if there are additional factors that may impact the success of the procedure and overall outcomes. It is important for patients to communicate openly with their healthcare provider about any digestive issues they may be experiencing to ensure the best possible results from the surgery.

Suitable For

Patients who are typically recommended colectomy include those with severe colonic inertia (CI) that does not respond to conservative treatments such as dietary changes, laxatives, and biofeedback therapy. Patients with CI may experience symptoms such as chronic constipation, bloating, abdominal pain, and difficulty passing stool.

In some cases, patients with CI may also have underlying conditions such as pelvic floor dysfunction, irritable bowel syndrome (IBS), or connective tissue disorders that contribute to their symptoms. These patients may benefit from colectomy as a last resort treatment option to improve their quality of life and alleviate their symptoms.

Additionally, patients with certain complications of CI such as colon dilation, fecal impaction, or recurrent bowel obstructions may also be candidates for colectomy to prevent further complications and improve their overall health. Patients with CI who have not responded to other treatments and have a significantly impaired quality of life may also be considered for colectomy.

It is important for patients considering colectomy to discuss the potential risks and benefits of the surgery with their healthcare provider and to explore other treatment options before making a decision. The decision to undergo colectomy should be made on a case-by-case basis, taking into consideration the individual patient’s medical history, symptoms, and overall health.

Timeline

Before colectomy:

  1. Patient experiences symptoms of colonic inertia, such as chronic constipation, abdominal pain, bloating, and difficulty passing stool.
  2. Patient undergoes various diagnostic tests, such as colonoscopy, transit studies, and pelvic floor testing, to determine the cause of their symptoms.
  3. After a diagnosis of colonic inertia is confirmed, the patient may be prescribed medications, dietary changes, and other conservative treatments to manage their symptoms.
  4. If conservative treatments are ineffective, the patient may be recommended for colectomy surgery, which involves removing all or part of the colon.

After colectomy:

  1. Following colectomy surgery, the patient will experience a recovery period in the hospital, where they will be monitored for complications and gradually transitioned back to a normal diet.
  2. The patient may experience initial discomfort, pain, and changes in bowel habits as their body adjusts to the surgery.
  3. Over time, the patient’s bowel function may improve, with some individuals experiencing relief from their constipation symptoms.
  4. However, some patients may continue to experience ongoing issues with constipation, especially if they have underlying upper gastrointestinal dysmotility issues.
  5. Patients will be monitored closely by their healthcare team post-surgery to address any complications, manage symptoms, and optimize their quality of life.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with colectomy surgery?
  2. How long is the recovery period after colectomy surgery?
  3. Will I need to make any lifestyle changes or follow a special diet after the surgery?
  4. What are the long-term effects of colectomy surgery on bowel function?
  5. Are there any alternative treatments or therapies for colonic inertia that I should consider before opting for surgery?
  6. How likely is it that my symptoms of constipation will improve after colectomy surgery?
  7. What is the success rate of colectomy surgery for patients with colonic inertia?
  8. Will I need to take any medication or undergo additional procedures post-surgery to manage any potential complications or symptoms?
  9. How often will I need to follow up with you after the surgery for monitoring and potential adjustments to my treatment plan?
  10. Are there any specific tests or evaluations that should be done to assess my upper gastrointestinal system before proceeding with colectomy surgery?

Reference

Authors: Dourado J, Garoufalia Z, Emile SH, Wignakumar A, Rogers P, Weiss BP, Meknarit S, Mavarantonis S, Wexner SD, DaSilva G. Journal: J Clin Gastroenterol. 2025 Feb 1;59(2):129-137. doi: 10.1097/MCG.0000000000002112. PMID: 39652425