Intestinale Transitstörungen

Chronic constipation is one of the most frequent gastrointestinal symptoms with significant increase of prevalence in the elderly. In the absence of risk factors (e.g., colonoscopy screening for persons > 50 years of age), symptomatic therapy according to the guideline algorithms is recommended. In the absence of therapeutic success and/or suspicion of anorectal dysfunction, diagnostic workup of anorectal function is mandatory for targeted therapy (biofeedback, surgery). Intestinal transit disorders may cause persistent, increasing and/or therapy-resistant symptoms. Small intestinal transit as measured by hydrogen–lactulose breath test and large bowel transit as measured by radiopaque markers (Hinton test) may be obtained in routine gastroenterological investigation. However, specific investigations such as small and/or large intestinal manometry and histological evaluation of the enteric nervous system may be obtained in neurogastroenterological centers. These investigations are prerequisite for complex therapeutic interventions such as subtotal colectomy in slow transit constipation.