Colon non tumor
Non-neoplastic, non-congenital lesions
Idiopathic constipation

Author: Raul S. Gonzalez, M.D. (see Authors page)

Revised: 9 January 2017, last major update September 2013

Copyright: (c) 2003-2017, PathologyOutlines.com, Inc.

PubMed Search: idiopathic constipation
Cite this page: Idiopathic constipation. PathologyOutlines.com website. http://pathologyoutlines.com/topic/colonidiopathicconstipation.html. Accessed May 29th, 2017.
Definition / general
  • Severe and chronic constipation, typically secondary to neuromuscular abnormalities (severe idiopathic constipation) or chronic laxative use (cathartic colon), though may be of unknown cause
Terminology
  • Also called slow transit constipation or Arbuthnot Lane's Disease
Epidemiology
  • Usually women
  • May arise in childhood
  • Constipation may affect up to 30% of patients in U.K. (Nurs Times 2005;101:59)
Pathophysiology
  • Reduced ability of colon to propel waste
  • Cathartic colon is probably an end stage form of idiopathic constipation, as many patients become reliant on laxative use
Clinical features
  • Reduced amount of defecation, or increased difficulty in expelling stool
  • Bloating, fullness, abdominal pain
Radiology description
Treatment
Gross description
Microscopic (histologic) description
  • Normal in some cases
  • Melanosis coli due to laxative use
  • May have loss of neurons in myenteric plexus with silver stains
  • May have reduced interstitial cells of Cajal, ganglion cells and intraganglionic neurofilaments (Gastroenterology 1985;88:26, Gastroenterology 2002;123:1459, Gut 2002;51:496)
  • Atrophic muscularis propria with decreased neurons in Auerbach plexus
Positive stains
  • Silver stains and CD117 may highlight loss of neurons and interstitial cells of Cajal