Total colectomy is extremely effective for slow transit constipation confirmed on marker studies, as it removes the entire large bowel, whose function it is to absorb water thereby concentrating faeces making them firm. Very few nutrients are absorbed by the colon, so nutritional deficiency following this operation is rare. Although this type of surgery is generally able to be performed by key-hole (laparoscopic) methods, it is nonetheless major surgery, and carries a 5% risk of leakage of the anastomotic join between small bowel and rectum. Therefore, the potential benefits need to be carefully weighed against the potential hazards of this surgery.
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