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The structural and morphological impairment of the enteric nervous system (ENS), along with the dysfunction of interstitial cells of Cajal (ICCs) and smooth muscle cells (SMCs), are the primary contributors to the onset and progression of STC. In recent years, traditional Chinese medicine (TCM) has emerged as an alternative for the therapeutic prevention and treatment of STC. Metabolites obtained from botanical drugs, including quercetin and nobiletin, may ameliorate symptoms of STC, presenting a possible therapeutic approach for STC. This review summarizes metabolites derived from botanical drugs, including flavonoids, terpenoids, steroids, polysaccharides, anthraquinones, and phenylpropanoids, emphasizing their regulatory mechanisms in the treatment of STC via the ENS-ICC-SMC pathway, while also addressing future challenges and developmental directions.<\/jats:p>","DOI":"10.3389\/fphar.2025.1598806","type":"journal-article","created":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T11:40:37Z","timestamp":1749642037000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Protective effects of medicinal plant-derived metabolites on slow transit constipation via the ENS-ICC-SMC pathway"],"prefix":"10.3389","volume":"16","author":[{"given":"Zu","family":"Gao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liwen","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjun","family":"Bai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junwei","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,6,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1186\/s40360-023-00671-0","article-title":"\u03b2-sitosterol attenuates high-fat diet-induced hepatic steatosis in rats by modulating lipid metabolism, inflammation and ER stress pathway","volume":"24","author":"Abo-Zaid","year":"2023","journal-title":"BMC Pharmacol. and Toxicol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"488","DOI":"10.1038\/mt.2015.7","article-title":"Targeted gene delivery to the enteric nervous system using AAV: a comparison across serotypes and capsid mutants","volume":"23","author":"Benskey","year":"2015","journal-title":"Mol. 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