Mechanisms and Management of Chronic Constipation

  • James C. Reynolds
Part of the Topics in Gastroenterology book series (TGEN)


The mechanisms of chronic constipation are complex and vary in severity from a dietary deficiency of fiber to a diffuse systemic neuropathy. Most patients with milder degrees of constipation will respond promptly to an increase in dietary fiber.1–3 In fact, epidemiologic studies indicate that many colonic disorders that are endemic to Western nations, including the irritable bowel syndrome (IBS), constipation, and colon cancer, occur rarely in societies that injest higher quantities of dietary fiber.4,5 In contrast, there are increasing reports about the medical and surgical treatment of more intractable forms of constipation.6–12 Figure 1 shows the abdominal x-rays of a patient with severe constipation due to anal sphincter dysfunction. The diagnosis went unrecognized for over a decade, and thus led to years of discomfort that could have been avoided by earlier treatment. Data from several centers suggest that in a subset of patients, constipation may be the presenting symptom of a diffuse disorder of enteric and autonomic nerves.7,10 An increased understanding of the mechanisms of constipation will lead to a more rational approach to the diagnosis and treatment of patients suffering from this condition.


Irritable Bowel Syndrome Dietary Fiber Anal Sphincter Internal Anal Sphincter Chronic Constipation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Plenum Publishing Corporation 1989

Authors and Affiliations

  • James C. Reynolds
    • 1
  1. 1.Department of Medicine and PhysiologyHospital of the University of PennsylvaniaPhiladelphiaUSA

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