Slow Transit Constipation: A True Enteric Neuropathy

Never apologize for a messy house.  (Reader, move on if this isn’t your deal.)

English: Pedestal squat toilet

English: Pedestal squat toilet (Photo credit: Wikipedia)

You’d think that being a not-so-old medical doctor, even now just eight years out of training, I would have known more about constipation than I did.  But I didn’t.  And the doctors I went to for help didn’t seem to know either.  I do remember one elderly OB/Gyn admitting that he didn’t know what to tell me to do, but to certainly do something; he had a friend who had severe constipation and had to have a colectomy (part of his colon cut out).  My OB/Gyn admitted, “I didn’t know constipation could get so bad.”  I appreciated his acknowledgement of the potential gravity of the situation.  However, nobody seemed to offer me anything helpful, and I just muddled through with various over the counter products with occasional, temporary success.  Luckily for most of my life, my slow transit was relatively asymptomatic (at least between bowel movements, which gave me quite a symptom-free interval—chuckle) and unaccompanied by too many other symptoms, until the last few years.

Since I got the awesome opportunity to homeschool my kids, I had just a couple of hours here or there to start reading for myself, so I could hopefully avoid that colectomy.  The first article that made me celebrate a couple of years ago was something about “fiber doesn’t help slow transit constipation (STC), in fact, it may make it worse.”  Validation of my own experience, counter to most suggestions from my own doctors and training!  However, mostly in my early searches, I came across depressing, belittling stuff like this (emphasis mine):

Now, I am beginning to read lines like this, helping me to see that, although research doesn’t know the answers, at least they’ve identified a REAL problem and there are researchers out there “fighting for me” (and my psychological profile):

Right.  So now I’ve got a nice review article to validate my personal knowledge that no matter what I try, nothing works great because I’ve got a real problem.  A problem that goes beyond trying  fiber, water, and yoga.  A problem beyond, “Well, you must have held your poop in too much when you were a kid so you wouldn’t have to poop in public places.”  Please.

So what is wrong down there?  A true problem with the nervous system and hormonal system of the gut, now in its early infancy of identification.  Science history in the making.

Thanks for reading.  I’m working up to my butyrate post.


Next up, Part Two:  Why Does My GI Tract Defy Physiology and Gravity?
(Alternate Titles To Amuse My Sense of Humor:  “Everybody Else Can Poop, Why Can’t I?”  or “Thank My ENS I Don’t Have To Touch The Toilet Bowl Brush!”)

3 thoughts on “Slow Transit Constipation: A True Enteric Neuropathy

  1. IrishMum

    My eldest son suffered with constipation from a young age too. I brought him to numerous specialists, all telling me to up his fiber, which I did. But things didn’t get any better, in fact they deteriorated. It was only when we went wheat free that I saw huge change for him. Now on eating Paleo he has no issues, but any slips are quickly noticed.

    1. thehomeschoolingdoctor Post author

      Ditto! My middle child had the worst constipation. I felt awful. I knew there was “nothing to do,” and that’s what all our doctors (who we “hand-pick” you know!) said, too. Even as a solely nursed baby she’d have huge gaps in her bowel routine, like 7 or so days between. For her, we discovered two years ago it was dairy. But here is one instance I feel GAPS MAY have helped, with its broths, fermented foods, food inclusion/exclusion list. She can now eat some dairy and mainstream foods with “no” effect. However, she prefers to keep that to a minimum. Early on in GAPS, she had problems with nuts and nut products, but that disappeared, too. Who knows. However, eating clean is the best thing for her nutritionally and physiologically speaking. Thanks for your comment (so I could write a book in response to your comment!). I know other moms I talk to also have this problem with their children, but they are afraid to take “the plunge.” I wish I could say more to help them.

  2. Pingback: Butyrate and Constipation | The HSD

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