Diminished colonic peristalsis or rectal insensitivity to fecal masses. Etiology Colonic inertia occurs in elderly or invalid patients, especially if bedridden. The colon does not respond to the usual stimuli that promote evacuation, or accessory stimuli normally provided by eating and physical activity are lacking. Inertia sometimes occurs in patients whose rectal sensitivity to fecal masses is dulled by habitual disregard of the urge to defecate or by prolonged dependence on laxatives or enemas, often initiated in childhood. Drugs frequently compound the problem.
Fecal impaction is common.
The principal symptom is constipation without abdominal discomfort. The urge to defecate is decreased, and stools are often putty-like or soft and not scybalous. Rectal examination frequently discloses an ampulla full of feces, yet the patient has no urge to defecate and cannot do so effectively, even with effort. Proctoscopic and barium enema examinations are normal, although evacuation of the contrast medium may sometimes be difficult and the colon may appear unusually redundant and capacious. Treatment Treatment is adapted to the patient's general status.