Colonic Inertia Treatment Options

There is no standard treatment for colonic inertia.  Most clinicians will recommend changes to your diet to see if that provides relief of symptoms.

Medications

It is not uncommon for individuals with colonic inertia to begin to use stimulant as a treatment.

It is important to know that excess stimulant laxative use can trigger worsening constipation and possible damage to the colon.  It is believed that use of stimulant laxatives on a long-term (chronic) basis can result in additional damage to the nerves and muscles of the lower intestine, and may eventually lead to cathartic colon [a condition where the colon fails to function properly because it has been damaged by the laxatives].

If changing your diet does not result in relief, other medication may be indicated. In addition to traditional laxatives, new prescription agents exist for constipation such as tegaserod (Zelnorm) and Lubiprostone (Amitiza) and Linzess (linaclotide), among others.   This may take some time and trial and error to determine which regimen works best for you.  Each patient will respond differently.

Biofeedback

Some patients with colonic inertia may benefit from biofeedback.  Biofeedback can play an important role in retraining the anal sphincter or pelvic floor muscles. Biofeedback works by retraining muscles to relax during evacuation and to contract at appropriate times. Computer feedback shows patients the pelvic floor muscle strength and provides immediate data on exercise performance accuracy. Used in conjunction with outpatient exercises, biofeedback strengthens muscles, improves coordination, and teaches patients to avoid straining.

Surgery

Surgery has been found to be effective in some patients who have colonic inertia.  It is only considered in the most severe cases and is reserved for those patients that have failed other conservative measures.  The surgery for this condition involves the removal of the majority of the colon (colectomy) with reconnection of the small intestine to the rectum (ileorectal anastomosis) or colectomy with the creation of a permanent ileostomy. In some patients with colonic inertia, this type of surgery may result in complete improvement of their symptom.

The success rate in patients who also have small intestine dysmotility is less than favorable.

Surgery treats the symptom of constipation, but usually does not treat the other symptoms that are seen in colonic inertia, such as abdominal pain.