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What Is Slow Gut Transit Constipation?
Slow transit constipation is just one type of constipation. It occurs when the muscles in the colon do not work correctly, leading to constipation (1).
Symptoms can include the following (1);
- pain
- blood in stools
- bloating or distension
- straining when opening bowels
Sometimes it can be so difficult for an individual to open their bowels that they have to use their fingers to help them go or they may even suffer with overflow diarrhoea.
Diagnosis
Firstly, your GP will likely assess your symptoms to make sure they are not related to any medications that you may be on. They may even want to do blood tests to rule out certain conditions. After this, your GP will rule out your diet and lifestyle as a cause by sending you to a dietitian.
If no cause is found, you will then need to see a gastroenterologist. Further testing such as blood tests and colonoscopy will be used to rule out more causes of your constipation. If no cause is found, physiologic testing will be carried out to assess how well your gut is working (1).
What Causes Slow Gut Transit?
Research suggests that slow gut transit it could be caused by a problem with the signalling between the nerves and the muscles in the colon (2, 3).
How To Manage Slow Transit Constipation
Fibre
The use of fibre in digestive health in general is not clear cut.
A slow increase in fibre and or fibre supplement is recommended by American Gastroenterology Association (3).
However, a trial providing increases in soluble fibre of 15 -30g showed that 85% of the individuals with slow transit gut constipation did not have improved symptoms (4).
Soluble fibre is effective in reducing all IBS symptoms (5).
Synbitoics
A relatively new study has shown the use of synbiotics can help resolve the symptoms of slow transit constipation (6).
Synbiotics are a combination of probiotics and prebiotics.
In the study, 46% of the individuals experienced full symptom relief after 12 weeks compared to only 13% in the ‘placebo group.’
Fluid
Traditionally, having a good fluid intake is pushed as being important to prevent constipation.
In actual fact (as with all things diet!) – it isn’t that straight forward.
There is no scientific evidence to prove that increasing fluid can help with constipation at all.
Instead, what we have is a few, small studies, that suggest a link between a low fluid intake and constipation.
In one study, of just 8 people, a fluid intake of less than 500mls per day, reduced how often they opened their bowels. Although the individuals didn’t open their bowels as much, they still were not technically ‘constipated’ (7).
The problem with this study is that the individuals in it did not have slow transit constipation. So it doesn’t really give us any accurate idea of how a low fluid intake may affect those that do have it.
All this study does do is suggest that fluid has a role in helping to maintain regular bowel movements.
As a healthcare professional, we are often left with poor research like this. So, what do we suggest? Well, given that having an adequate fluid intake has other benefits, I would suggest that there is more benefit in making sure individuals have enough fluid than any risk.
Fluid intake should be around 35mls/kg body weight. This is only a rough guide and if you do excessive exercise or have a medical condition such as kidney disease, your fluid intake will need to be modified. To get more accurate advice, please see a registered dietitian who can assess you on a 1-2-1 basis.
FODMAPs
FODMAPs are a fermentable carbohydrates which can cause bloating and / or loose stools in some people.
While going on a low FODMAP diet will not increase how often a person opens their bowels, it has been shown to help with other symptoms such as bloating in those with IBS (8).
As bloating is a common symptom in slow transit constipation, the low FODMAP diet may help those with slow transit constipation.
Exercise
Exercise is known to help with improving the time it takes for food to move through your gut. In one study, it was shown that doing a 30 minute walk each day significantly improved constipation (9).
Medical Management
Needless to say, if you have any of the symptoms mentioned in this article, please see your GP.
As with many other digestive health problems, the symptoms of slow gut transit are not very specific. In other words, the symptoms may be a cause of something more sinister – so just get checked out.
In the case that you do have slow gut transit, your doctor will be able to advise you on the best medical treatments going forward. These will depend on the cause of your symptoms.
Your doctor will also advise that you make changes to your diet. So that you are not making your symptoms worse, it is advisable to see a specialist in digestive health dietitian.
Summary
- Slow transit constipation is constipation caused by the muscles in your colon not working effectively.
- Symptoms of slow transit constipation should be reported to your GP.
- Fibre, fluid, exercise and synbiotics may all help to improve the symptoms of slow transit constipation. However, focusing on just 1 area is unlikely to provide any benefit.
- There are also a range of medications and medical procedures that can help with slow transit constipation.
- You should see a specialist dietitian to ensure your dietary changes do not worsen your symptoms.
Kirsten Jackson is a UK registered Consultant Gastroenterology Dietitian and founder of The Food Treatment Clinic. She has undergone many qualifications to get where she is today, including a UK BSc Honours Degree in Dietetics and Post-Graduate Certificate in Advanced Dietetics. In addition to this, she has FODMAP Training from Kings College London University. Kirsten set up The Food Treatment Clinic in 2015 after first experiencing digestive problems herself. She felt that the NHS was unable to provide the support individuals needed and went on to specialise in this area before opening a bespoke IBS service. Kirsten also participates in charity work as an Expert Advisor for the IBS Network. In addition, she can be seen in publications such as Cosmopolitan and The Telegraph discussing IBS as an Official Media Spokesperson to the IBS Network.
Of i weigh 136 how much food shou l i drink?
Hi Marjorie, it is difficult to tell you without doing a full assessment. Calorie requirements are based on age, sex, physical activity, body composition, job type etc. I would suggest you book in for an assessment.
Hi Krystal, I think the problem is that doctors need to be referring you to a dietitian after they do their bit at the diagnosis – push for a dietitian referral! We would love to have you as a client here 🙂
My weight has been stalled at 14 st for 3 years. (4st overweight). At that time, I found it difficult to go to the toilet. This got so bad and I went to the Dr. They eventually diagnosed STC. I am on high antidepressants and am now totally constipated unless I take Dulcolax which is absolutely the only thing that works for me. The Dr has said to just keep taking the laxatives BUT the STC and weight gain are totally unrelated and just bad coincidence. The dietician I saw said they didn’t know what to advise me to eat or drink. Please help. I’m so desperate to sort one or both out.
Hi Samantha,
Thank you for your message, I am so sorry to hear this. Book in for one our complimentary calls on the booking page and we can have a chat to find out what the best course of action is for you.
Hi I wanted some advice I was diagnosed with slow transit bowel, hiatus hernia and Barrett’s syndrome last summer. The treatment the doctor has give is linaclotide and omeprazole. The linaclotide worked at first now it doesn’t. I have been to my GP and they said nothing they can do for me apart from taking ducolax on top of medicines already. I literally cannot open my bowels for up to 2 weeks at a time. I don’t know what to do and feel sick every day. Any advice would be appreciated.
Hey! Yes of course – if you search the site we have a post on this condition. But I would say that you need to see a dietitian for 121 support as everyone is different so please do go to our booking page and grab a free 15 minute consult 🙂
A few year’s ago I was diagnosed with slow transit. Recently things are much worse. Really bad constipation followed by diarrhoea for a week with Tummy pain. What do I do next?
Hi Olivia! I am so sorry to hear that you are struggling with this. Unfortunately we cannot give dietary advice without further assessment. However, if you would like to work with us, please do email us on admin@thefoodtreatmentclinic.com and we will be more than happy to help!
Hi my name is Gabriela. I’ve recently been diagnosed with Slow Transit Constipation. I need a better understanding of a diet specifically for my condition. I’m all over the place, reading different stuff but can’t come to conclusion as to what I am able to eat to help me without further suffering. Any advice would be greatly appreciate. Thank you
Hi Gabriela, thank you for your comment! I would try to follow the steps in this post first and see how you get on. If this doesn’t work then it is likely you need a more 121 approach. You can book in for a complimentary phone call under our contact page and find out what we can do for you 🙂 Kirsten xx
Dear Kristen,
I suffer from idiopathic slow transit constipation. I believe it’s due to my abuse of laxatives. Would you be able to help with my diet and excercise? Kind regards,
Nina
Hi Nina, Thank you for your comment. We will email you back – please check your junk in case you do not receive the response :).
Hello,
I have had constipation since I was a child. I am 64 now and my life is miserable. I suffer with abdominal cramps, nausea, no appetite, bloating and muscle spasms. It is usually takes more than 2 weeks without a bowel movement while taking laxatives and enemas. My gastroenterologist has tried various medications which often cause diarrhea ( which is actually a relief) but after a few days while on the medication, I am again constipated. Fiber rich diets cause bloating and pain, drinking half a gallon of water daily only increases urine output, due to nausea ,I manage a few bites of food and muscle pain and fatigue limits exercise. I push hard to have a bowel movement until exhausted. I feel that my uterus blocks my rectum and there is a pocket near my anus so I often insert a finger into my vagina to push stool out. Right now, I live just to complete things that I want to leave to loved ones and I constantly think about my best way to end my misery.. My doctor will not operate because I have a 98 percent chance of bleeding to death which doesn’t frighten me..
PLEASE help me perhaps by offering more information about treatments or provide names of doctors who specialize in slow transit colon. I had the x-ray test with beads, after 2 weeks the beads traveled half way into my colon. I don’t want to hurt my family by choosing suicide but I can’t keep forcing a smile on my face and act fine when I feel I am dying a slow torturous life.
Maybe there are other options or doctors who specialize in this type of illness that someone can offer information about. I would appreciate anything that could give me some hope.
Thank you.
We are so sorry that you are going through this, please can you email us admin@thefoodtreatmentclinic.com so we can discuss in private and get you the best possible solution.