Difference Between Atonic and Spastic Constipation

Constipation is a well known gastrointestinal problem that millions of individuals experience globally. Usually, it is characterized by a sensation of incomplete evacuation, difficulty passing stool, and irregular bowel motions. Atonic and spastic constipation are two diffrent forms with different underlying mechanisms and treatment methods that features difficulty with bowel movements and abdominal discomfort. Stress, dietary choices, and lifestyle decisions can affect both types, but their particular triggers and mechanisms are different.

Comparison Table: Atonic vs. Spastic Constipation

Feature Atonic Constipation Spastic Constipation
Primary Cause Lack of muscle tone in the colon Spasms in the colon
Common Triggers Poor diet, sedentary lifestyle, medications Stress, anxiety, dietary triggers
Bowel Movement Infrequent, hard, and dry stools Alternating constipation and diarrhea
Abdominal Pain Generally mild discomfort Cramps and pain relieved by bowel movement
Stool Characteristics Hard and dry May include mucus, variable consistency
Diagnostic Methods Colonic transit study, anorectal manometry Rome IV criteria, stool tests, colonoscopy
Treatment Dietary changes, exercise, medications Dietary modifications, stress management, probiotics

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What is Atonic Constipation?

Atonic constipation is also known as colon status or lazy colon is a type of constipation caused by a lack of muscle tone in the colon, leading to weak or absent peristaltic movements necessary for moving stool through the intestines.


  • Lack of muscle tone in colon
  • Weak peristalsis movement that is necessary for the movement of stool
  • Dietary factors like law fiber intake
  • Leading a sedentary lifestyle
  • Certain medications, such as opioids and anticholinergics, can reduce bowel motility.
  • Medical conditions: Diabetes, hypothyroidism, and neurological disorders can contribute to atonic constipation.


  • Infrequent bowel movements (less than three times per week)
  • Hard, dry stools
  • Straining during defecation
  • A feeling of incomplete evacuation
  • Bloating and abdominal discomfort


  • Medical history: A detailed history of symptoms, dietary habits, and lifestyle.
  • Physical examination: Abdominal examination to detect distension or tenderness.
  • Colonic transit study: Measures the time it takes for food to move through the colon.
  • Anorectal manometry: Assesses the strength and coordination of pelvic floor muscles.

Treatment and management

  • Dietary changes: The primary treatment method will be making dietary changes like Increasing fiber intake (fruits, vegetables, whole grains) and drinking plenty of water.
  • Exercise: Regular physical activity to stimulate bowel movements.
  • Medications: Bulk-forming laxatives, stool softeners, and, in some cases, prokinetic agents.
  • Behavioral therapies: Biofeedback therapy to improve pelvic floor muscle function.


With appropriate lifestyle modifications, including increased dietary fiber, hydration, and regular exercise, along with potential use of medications, atonic constipation can often be effectively managed. However, chronic cases may require ongoing treatment and monitoring.

What is Spastic Constipation?

Spastic Constipation is also known as Irritate bowel syndrom and constipation (IBS-C) is indicated by colon spasms, which can cause episodes of diarrhea and constipation alternatively This type of constipation is often associated with stress, anxiety, and certain dietary triggers.


  • Dietary triggers: Foods such as dairy, gluten, and high-fat meals can trigger spasms.
  • Psychological factors: Stress, anxiety, and depression can exacerbate symptoms.
  • Hormonal changes: Fluctuations in hormones, particularly in women, can affect bowel function.
  • Gut-brain axis dysregulation: Abnormal communication between the gut and the brain can lead to altered bowel habits.


  • Alternating constipation and diarrhea
  • Abdominal cramps and pain relieved by bowel movements
  • Stools accompanied by mucus and blood
  • Bloating and gas
  • Urgency to defecate
  • Irregular periods and acne in some cases


  • Rome IV criteria: A set of guidelines for diagnosing IBS, which includes recurrent abdominal pain and altered bowel habits.
  • Stool tests: To rule out infections and inflammatory diseases.
  • Colonoscopy: To examine the colon for any structural abnormalities.
  • Psychological assessment: To evaluate stress and anxiety levels.

Treatment and Management

  • Dietary modifications: Low FODMAP diet to reduce fermentable carbohydrates.
  • Medications: Antispasmodics, fiber supplements, and laxatives as needed.
  • Probiotics: To improve gut flora and reduce symptoms.
  • Stress management: Cognitive-behavioral therapy, mindfulness, and relaxation techniques.
  • Regular physical activity: To enhance overall gut health and reduce symptoms.

Prognosis for Spastic Constipation

Managing spastic constipation involves addressing stress and dietary triggers. With customized dietary modifications, stress management techniques, and possibly medications, many individuals experience significant symptom relief. However, it can be a chronic condition requiring long-term management strategies.

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What is Atonic Constipation?

Atonic constipation is also known as colon status or lazy colon is a type of constipation caused by a lack of muscle tone in the colon, leading to weak or absent peristaltic movements necessary for moving stool through the intestines.

What are common symptoms of atonic constipation?

Symptoms include infrequent bowel movements (less than three times per week), hard, dry stools, straining during defecation, a feeling of incomplete evacuation, and bloating or abdominal discomfort.

What causes atonic constipation?

Causes include a low-fiber diet, inadequate hydration, sedentary lifestyle, aging, certain medications, and medical conditions such as diabetes and hypothyroidism.

What is spastic constipation?

Spastic constipation, also known as irritable bowel syndrome with constipation (IBS-C), is characterized by spasms in the colon, leading to alternating periods of constipation and diarrhea.

What are common symptoms of spastic constipation?

Symptoms include alternating constipation and diarrhea, abdominal cramps and pain relieved by bowel movements, mucus in the stool, bloating, and gas.