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Constipation in ulcerative colitis: pathophysiology and practical management
  1. Charles Miller1,
  2. Anton Emmanuel1,2,
  3. Natalia Zarate-Lopez1,
  4. Stuart Taylor3,
  5. Stuart Bloom2,4
  1. 1Gastroenterology Department, University College London Hospitals NHS Foundation Trust, London, UK
  2. 2University College London, London, UK
  3. 3UCL Centre for Medical Imaging, Charles Bell House, 43-45 Foley street, University College London, London, UK
  4. 4University College London Hospitals NHS Foundation Trust, London, UK
  1. Correspondence to Dr Charles Miller, Gastroenterology, University College London Hospitals NHS Foundation Trust, London NW1 2PG, UK; charles.miller{at}


Clinical experience suggests that there is a cohort of patients with refractory colitis who do have faecal stasis that contributes to symptoms. The underlying physiology is poorly understood, partly because until recently the technology to examine segmental colonic motility has not existed. Patients are given little information on how proximal faecal stasis can complicate colitis. Treatment guidelines are scanty and many patients are offered little apart from laxatives and advice on increasing fibre intake, which often makes symptoms worse. This article aims to review the history, pathology and management, and create impetus for future research on this underappreciated condition.

  • constipation
  • ulcerative colitis
  • inflammatory bowel disease

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  • Collaborators C P Miller; A Emmanuel; N Zarate-Lopez; S A Taylor; S L Bloom.

  • Contributors CM came up with the concept of the article and authored the article. SB came up with the concept of the article and gave critical review, made revisions and recommendations. SB is the senior author on the article. AE, NZ-L and ST made critical review of article, made revisions and recommendations.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests ST is a shareholder in company Motilent. He is also a research consultant to Robarts.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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