Diagnosis of dolichocolons and coloptosis based on the results of X-ray studies in a specialized institution

Objective. To determine the frequency and pattern of incidence of dolichocolon and coloptosis in patients with chronic constipation and recurrent abdominal pain syndrome.

Materials and methods. A retrospective, single-center descriptive study was conducted. A total of 206 patients were examined for the period from January 2023 till December 2025. There were 82 men and 124 women. The average age of the patients was 51.5 years old. Inclusion criteria were recurrent abdominal pain syndrome, either with or without chronic constipation (group 1) or without constipation (group 2). Exclusion criteria included previous colon surgery, acute inflammatory processes in the colon and abdominal cavity, and the impossibility of performing an irrigoscopy for medical reasons. Barium enema or irrigography was performed, assessing the position of the colon in both horizontal and vertical positions.

Results. Complaints of chronic constipation and intermittent abdominal pain were in 160 patients (group 1), while recurrent pain syndrome presented only in 46 patients (group 2). Thirty-three (21%) patients in the first group were diagnosed with dolichocolon, 13 (8%) patients were diagnosed with coloptosis, and 61 (38%) patients had a combination of dolichocolon and coloptosis. Other causes of constipation were found in 38 (24%) patients (psychogenic constipation, poor diet, physical inactivity, medication use, endocrine disorders). Additionally, 15 (9%) patients in this group were diagnosed with colon cancer. In 46 patients of the second group, no anatomical changes in the form of dolichocolon and coloptosis were detected despite other diseases of the colon.

Conclusion. The obtained results confirm the need for a comprehensive radiographic approach in examining patients with chronic constipation, as well as the diagnostic value of barium enema andirrigography as methods of choice for assessing the length, configuration, and abnormal mobility of the colon. Examination in the upright position is key to identifying unstable (mobile) coloptosis, which is inaccessible to endoscopic methods. Examination of a patient in an upright position is a key one to identifying unstable (mobile) coloptosis, which is inaccessible to endoscopic methods. Timely diagnosis of dolichocolon and coloptosis allows accuratly determination of the cause of the obstructed passage and facilitates the selection of optimal treatment policy, preventing complications of chronic intestinal dysfunction.

1. Clinical guidelines for the diagnosis and treatment of adult patients with dolichocolon. Expert commission of the All-Russian Public Organization "Association of Proctologists of the Russian Federation." Moscow, 2013. – 16 p. (in Russ.)

2. Rosenshtraukh L.S., Salita H.M., Gutsul I.P. Clinical X-ray diagnostics of intestinal diseases. Chisinau: Shtiintsa, 1985. – 254 p. (in Russ.)

3. Raahave D. Dolichocolon revisited: An inborn anatomic variant with redundancies causing constipation and volvulus. World J Gastrointest Surg. 2018 Feb 27;10(2):6-12. doi: 10.4240/wjgs.v10.i2.6.

4. Dilmaghani S, Lupianez-Merly C, Fetzer J, BouSaba J, Halawi H, Camilleri M. Colon Volume by Computed Tomography and Scintigraphic Colonic Transit in Constipated Patients With or Without Redundant Colon. Clin Gastroenterol Hepatol. 2024 Nov;22(11):2327-2329.e2. doi: 10.1016/j.cgh.2024.04.009.

5. Raahave D. Dolichocolon revisited: An inborn anatomic variant with redundancies causing constipation and volvulus. World J Gastrointest Surg. 2018 Feb 27;10(2):6-12. doi: 10.4240/wjgs.v10.i2.6.

6. Lindenbraten L.D., Naumov L.B. Methods of X-ray examination of human organs and systems. T. "Medicine", Tashkent, 1976. - 420 p. (in Russ.)