Surgical Therapy of Constipation

The definition of constipation includes fewer than three bowel movements per week, straining at defecation, and/or hard pellet-like stools.

Constipation includes a constellation of symptoms influenced by local culture, geography, socioeconomic background, and the patient's personality.

Coexistence of weight loss and rectal bleeding suggests colorectal cancer.

Diagnosis should attempt to differentiate an extra-colonic or systemic cause from a mechanical or functional colonic cause.

The key to treatment is appropriate diagnosis.

Mechanical causes include diverticular stricture, colonic neoplasm, occult rectal prolapse, and rectocele.

Functional causes include slow transit constipation, irritable bowel disease, psychologic disorders, and pelvic floor dysfunction.

Diagnosis may involve combinations of colonoscopy, scintigraphic transit studies, anorectal physiologic testing, and defecating proctography.

Medical therapy for simple constipation involves a high liquid...