Slow transit syndrome and mechanisms of constipation (lazy bowel syndrome): current understanding of causes, diagnosis, and consequences

Abstract

Background. Slow transit syndrome and functional constipation (lazy bowel syndrome) represent a significant medical and social problem due to their high prevalence, chronicity, and significant reduction in quality of life. In clinical practice, this is a cluster of symptoms associated with impaired intestinal motor function, including infrequent and difficult bowel movements, abdominal bloating, a feeling of heaviness and discomfort, and the need for excessive straining or manual assistance during defecation. The prevalence of functional constipation, including slow-transit syndrome, remains extremely high in the population. According to contemporary epidemiological studies, constipation symptoms are observed in 12-19% of the adult population in economically developed countries, including the USA, the United Kingdom, Germany, and Italy. In the Russian Federation, the prevalence of chronic constipation corresponds to global averages, ranging from 14% to 35% among adults. This issue acquires particular medical and social significance in the elderly population. Among individuals over 60 years of age, the prevalence of constipation reaches 36%, with women affected three times more often than men. This pattern is likely associated with reduced physical activity, polypharmacy, the presence of comorbid neurological and endocrine disorders common in older age, as well as the natural involutional changes of the intestinal neuromuscular apparatus.
Results. This article presents the clinical characteristics of functional constipation and slow intestinal transit based on the Rome IV criteria, describes the necessary diagnostic measures, and highlights the stages of treatment. Particular attention is paid to the risks of long-term drug therapy and strategies for minimizing them.