Gut 51:496-501 doi:10.1136/gut.51.4.496
  • Motility and visceral sensation

Pan-colonic decrease in interstitial cells of Cajal in patients with slow transit constipation

  1. G L Lyford1,
  2. C-L He2,
  3. E Soffer3,
  4. T L Hull3,
  5. S A Strong3,
  6. A J Senagore3,
  7. L J Burgart4,
  8. T Young-Fadok5,
  9. J H Szurszewski2,
  10. G Farrugia2
  1. 1Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
  2. 2Division of Gastroenterology and Hepatology, and Department of Physiology and Biophysics, Mayo Clinic, Rochester, MN, USA
  3. 3Department of Colon and Rectal Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA
  4. 4Department of Pathology, Mayo Clinic, Rochester, MN, USA
  5. 5Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA
  1. Correspondence to:
    Dr G Farrugia, Mayo Clinic, Guggenheim 8, 200 First St SW, Rochester, MN 55905, USA;
  • Accepted 6 February 2002


Background: Interstitial cells of Cajal (ICC) are required for normal intestinal motility. ICC are found throughout the human colon and are decreased in the sigmoid colon of patients with slow transit constipation.

Aims: The aims of this study were to determine the normal distribution of ICC within the human colon and to determine if ICC are decreased throughout the colon in slow transit constipation.

Patients: The caecum, ascending, transverse, and sigmoid colons from six patients with slow transit constipation and colonic tissue from patients with resected colon cancer were used for this study.

Methods: ICC cells were identified with a polyclonal antibody to c-Kit, serial 0.5 μm sections were obtained by confocal microscopy, and three dimensional software was employed to reconstruct the entire thickness of the colonic muscularis propria and submucosa.

Results: ICC were located within both the longitudinal and circular muscle layers. Two networks of ICC were identified, one in the myenteric plexus region and another, less defined network, in the submucosal border. Caecum, ascending colon, transverse colon, and sigmoid colon displayed similar ICC volumes. ICC volume was significantly lower in the slow transit constipation patients across all colonic regions.

Conclusions: The data suggest that ICC distribution is relatively uniform throughout the human colon and that decreased ICC volume is pan-colonic in idiopathic slow transit constipation.