Colonic Inertia

Colonic Inertia Definition

Colonic Inertia is a condition where the muscles and nerves in the colon are not able to function normally which obstructs the excreta from passing via the colon. This leads to constipation. The real cause of colonic inertia is often not clear, but in most of the cases it is due to excess usage of laxatives which are stimulant or varied muscle and nerve ailments. While defecating, the nervous system sends some electric impulses to the specialized cells in the colon to trigger the contraction of muscles. People suffering from this condition have got decreased number of those cells.

Colonic Inertia Causes

Some of the main probable causes of this condition are:

Picture of Colonic Inertia

Picture 1 – Colonic Inertia

However, medical experts are still confused regarding the exact cause of the disease. Some of the possible reasons have been mentioned below:

  • Diabetes, which can lead to loss in the interstitial cells (also known as Cajal cells).
  • Infectious agents, which may lead to the degradation of the functioning of the enteric nervous system as well as affect the balance of intestinal flora.
  • A few women develop slow transit after a hysterectomy or childbirth which might damage some of the enteric nervous system.
  • Long term use of stimulant laxatives worsens the condition and the effect takes place on the neurological structures of the gut.
  • Abnormalities in natural process and genetic background may also be possible causes.

Colonic Inertia Symptoms

An extreme form of constipation is the most important symptom of the disease. This is because the colon holds on to the fecal matter too long than what it would normally do. This makes the stool dry and hard and makes it difficult to be expelled. This in turn triggers other discomforting sensations, such as:

  • Bloating
  • Abdominal distension
  • Vomiting
  • Nausea
  • Gas
  • Abdominal cramps

The symptoms differ in case of every individual and may not occur all at one time. Patients feel as if the intestinal contents never reach the rectum.

Colonic Inertia Diagnosis

People suffering from this condition have a feeling that their gut is full. They feel that fecal matter is stuck and does not move into the rectum. It can be pushed out once it makes it to the rectum.

A doctor will conduct a battery of tests. If the transition process is too slow, the physician will want to check your thyroid hormones. Doctors will also take a measurement test. The test will make use of X-Rays to follow small markers. The patient will asked to have special capsules for a few days and then an x-ray shot will be taken to check the position of the markers. Based on the number of markers present in different sections of the gut, this test will reveal the number of hours or the average time the transition takes. The average time for a normal person is 35 hours, although it can go up to 72 hours.

Colonic Inertia Treatment

There are several treatment options for the disorder:

Osmotic Laxatives

Osmotic laxatives can be tried as a means of treatment. These laxatives absorb water from the colon mucosa into the stools. They do not depend on the impaired nervous of the colon, they actually work through fluid exchange. Laxatives such as MiraLAX or other osmotic types can be a big relief to those who are suffering from colonic inertia.


Biofeedback uses special makes use of equipment to train the patient to relax her pelvic floor muscles. This treatment is particularly used for those who have pelvic floor dysfunction. Biofeedback provides the much needed relaxation of the pelvic floor muscles.

Colonic inertia Diet

Patients must have a high fiber diet. The diet must include vegetables, fresh fruits, beans and whole grains. Meat products, dairy products, processed tools. Foods high in fat and sugar, snacks like chips and pizza etc should be avoided. One should have good fats and not hydrogenated fats like margarines, croissants, or pie crusts from supermarket. Patients can also try having a little meat and check whether that is affecting the gut.

Proteins are a must in the diet for patients suffering from Colonic Inertia. Proteins contribute amino-acids which are vital for building up muscle mass and neuro cells in the colon. Beans contain a lot of protein. Protein powders of reputed companies can be mixed with several health drinks. Patients with constipation problems must avoid taking refined carbohydrates. Although they provide quick energy, they may also create a lot of bloating and gas as certain bacteria feed on carbohydrates and generate gas as their byproduct. Liquid diet is another option that helps people suffering from constipation. They may have problems to consume solid foods but find comfort in liquids. Fruit and veggie smoothies and other power drinks like almond milk, coconut milk can also help a lot.

Regular exercise is another measure to treat this colonic condition. Exercise helps to stimulate bowel, and keeps the digestive system in shape. Walking for 30-35 minutes daily assists a lot in managing conditions like colonic inertia and constipation.


If other non-surgical options fail to work, doctors are likely to suggest surgery for cure. Surgical techniques have been found to be effective in curing certain patients.

Following are some of the options for operative treatment:

Colectomy & Ileostomy

Colectomy involves the removal of a large portion of your colon that is malfunctioning. The exit of the small intestine is thus connected directly to the rectum. In some cases, the rectum and anus are bypassed to bring the end of the small intestine onto the surface of your abdomen. Following this step, a pouch is attached to collect the fecal matter. This surgery is known as Ileostomy and is suggested when there is concomitant pelvic floor dyssynergia. If one is found to develop both the combinations, doctors might suggest a Colectomy. Colectomy is followed by post surgery biofeedback instead of an Ileostomy. Here one does have to carry a pouch.

Image of Colonic Inertia

Picture 2 – Colonic Inertia Image

Antegrade Colon Enema

This is a minimally invasive procedure that opens up access to the colon through a tube. ‘Enema’ is the water inserted from the anus. Antegrade is the liquid which is inserted at the opening of the colon, through a tube which is pushed through an opening surgically created on the belly button or lower abdomen of a patient. The patient can self-administer those Antegrade enemas when required on a daily basis by pouring liquid through the tube. Antegrade Colon Enemas can bring a lot of improvements to slow transit constipation sufferers.


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