Impaired Motility

There are several factors that could cause impaired motility.

Slow-Transit Constipation (STC)

During STC, the transit of stool through the colon is slowed down, which causes bloating, abdominal pain, and infrequent trips to the bathroom.

It's caused by a neuromuscular disorder, where the muscles in the colon aren't working to move stool along as they should. Stool and secretions in the colon are delayed moving down to the rectum and this results in hard stools that aren't easy to pass.

Defecation Disorders

In defecation disorders, the muscles in the abdomen, rectum, anus, and pelvic floor aren't working as they should. This results in being unable to pass stool out of the rectum without considerable straining.

Bowel Obstruction

A potential complication of constipation from certain causes could be a bowel obstruction. An obstruction is when stool is blocking part or all of the intestine, and isn't moving along as it should, and might also be called fecal impaction.

A patient with or without CIC needs to be seen urgently if there is a large (or small) bowel obstruction.  While CIC is a nuisance, a bowel obstruction is a mortal risk.

One type of bowel blockage is called a partial obstruction, because the bowel is only party blocked, and sometimes liquid stool or gas can still be passed out the bottom. During a total obstruction the colon is completely blocked and stool can't pass through it at all. The abdomen may feel tender when it is touched or examined by a physician.

During a large bowel obstruction, the normal noises the bowel makes during digestion (borborygmi) may become very loud. The section of the bowel that is closest to the obstruction becomes bloated (distended). Bowel sections that are further away from the blockage may do the opposite, and collapse. The internal walls of the bowel slow down their functions, such as absorbing water and releasing digestive juices. 

If a bowel obstruction continues without being treated it could lead to parts of the bowel shutting down, tissue death from lack of blood flow, or a hole in the bowel wall (perforation), although this is rare.

As a result of this blockage, those with CIC may experience:

  • Abdominal bloating and pain

  • Feeling that there's more stool, even after a bowel movement

  • Hard or lumpy stools

  • Having bowel movements only infrequently (less than three times a week)

  • Painful bowel movements   

  • Straining to pass stools

In some cases, you may find that looser stools only occur with the use of laxatives, or you may feel that you need to use your fingers to dislodge stool.