Treatment
8
Figure 4. Treatment Algorithm for NTC and STC
Normal or slow transit
constipation
Laxatives (eg, PEG, MOM,
bisacodyl)
Continue
regimen
Modify regimen:
Consider newer
pharmacological agents
Improvement No Improvement
Continue
regimen
Repeat colonic transit test
(on medications)
Improvement No Improvement
Consider gastric emptying if
necessary
Adjust medications as
needed
Delayed Normal
Slow Normal
Consider further
assessment for upper GI
motility disorder
Abnormal Normal
Manage appropriately
Consider colonic
manometry ± barostat
Normal Abnormal
Consider subtotal
colectomy + ileorectal
anastomosis
Consider temporary
loop ileostomy
