Dolichocolon as an overlooked anatomical factor in chronic constipation: pathophysiology, diagnosis, and therapeutic implications

Pablo Weber Alvarez MD; Pablo Weber Alvarez MD

doi:10.15406/ghoa.2026.17.00631

eISSN: 2373-6372

Gastroenterology & Hepatology: Open Access

Research Article Volume 17 Issue 1

Dolichocolon as an overlooked anatomical factor in chronic constipation: pathophysiology, diagnosis, and therapeutic implications

Pablo Weber Alvarez MD, Pablo Weber Alvarez MD

General Physician, Hospital Ángeles Lomas, Huixquilucan, México
Department of General Surgery, Hospital Ángeles Lomas. Huixquilucan, México

Received: January 31, 2026 | Published: April 28, 2026

Citation: Alvarez PW, Sánchez AW. Dolichocolon as an overlooked anatomical factor in chronic constipation: pathophysiology, diagnosis, and therapeutic implications. Gastroenterol Hepatol Open Access. 2026;17(1):28-31. DOI: 10.15406/ghoa.2026.17.00631

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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
Conclusions: 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.