Abstract

Background: Chronic constipation is a highly prevalent gastrointestinal disorder affecting approximately 14–20% of the general population. Despite the availability of multiple therapeutic strategies, nearly half of patients report dissatisfaction with conventional treatments, reflecting the complexity and heterogeneity of its underlying mechanisms. 1
Objective: To analyze the role of dolichocolon as an underrecognized anatomical factor contributing to chronic constipation and to discuss its diagnostic and therapeutic implications.
Methods: A narrative review of the literature was conducted, focusing on the pathophysiology, clinical presentation, diagnostic criteria, and management of dolichocolon in patients with chronic constipation.
Results: Dolichocolon, characterized by elongation and redundancy of the colon, has been associated with slow colonic transit, increased symptom severity, abdominal distension, and pain.2 Diagnostic evaluation is primarily based on imaging studies such as barium enema and computed tomography colonography, with specific anatomical criteria used to define colonic redundancy. Although many individuals with dolichocolon remain asymptomatic, in selected patients it may represent a significant contributing factor to refractory constipation. Initial management is conservative; however, surgical intervention may be considered in severe, treatment-resistant cases, particularly when associated with dolichosigmoid and documented slow transit.3,4
Conclusion: Dolichocolon should be considered a relevant anatomical factor in the evaluation of chronic constipation, particularly in patients with persistent or refractory symptoms. Its recognition may improve patient stratification and support more individualized and effective therapeutic approaches, including surgical management in carefully selected cases.

Keywords

chronic constipation, redundant colon, dolichocolon, dolichosigmoid, barium enema, colectomy