Which of the following features is/are consistent with a diagnosis of colonic inertia?

d. Total bowel transit time of 96 hours

Colonic inertia, or slow transit constipation, is primarily a disease of young women. Despite attempts at initiating bowel movements with fiber supplementation, large doses of laxatives and enemas, normal bowel movement patterns are not established. The etiology of this condition is totally unknown, but a likely etiology is some aberration in the neurochemical control of the colon, possibly within the enteric nerves. Abnormalities within the neural elements of the myenteric plexus suggest that disturbances in neuromodulation of colonic motility may play a role in some patients. The treatment of colonic inertia has proved difficult and many patients have required subtotal colectomy to correct the severe constipation. Diagnosis of this condition is usually achieved by assessing colonic transit with various radio-opaque markers. After ingestion of such markers, sequential abdominal films are taken to assess movement of markers in each segment of the colon. Total transit time in normal subjects averages about 35 hours. Total transit time in excess of 72 hours is clearly abnormal.