Surgical treatment for constipation in children and adults

Functional constipation is one of the most common gastrointestinal disorders. In both children and adults, most patients are managed conservatively with good results. In this review, we focus on the surgical approach to constipation. Patients who lack the capacity to consistently have voluntary bowe...

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Bibliographic Details
Published in:Baillière's best practice & research. Clinical gastroenterology 2011-02, Vol.25 (1), p.167-179
Main Authors: Levitt, Marc A., MD, Mathis, Kellie L., MD, Pemberton, John H., MD
Format: Article
Language:English
Subjects:
Adult
Child
Colon - physiopathology
Colon - surgery
Constipation
Constipation - diagnosis
Constipation - physiopathology
Constipation - surgery
Defecation
Digestive System Surgical Procedures - adverse effects
Evacuatory disorders
Fecal incontinence
Gastroenterology and Hepatology
Humans
Patient Selection
Pediatric
Severity of Illness Index
Surgery
Treatment Outcome
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Description
Summary:Functional constipation is one of the most common gastrointestinal disorders. In both children and adults, most patients are managed conservatively with good results. In this review, we focus on the surgical approach to constipation. Patients who lack the capacity to consistently have voluntary bowel movements may need mechanical emptying of the colon through an enema program; for them, surgery to allow for antegrade enemas, (via the appendix or using a button device) is useful. Those patients with severe constipation not responsive to intense medical treatment may be candidates for other surgical interventions, such as resection of the dysfunctional colonic segment (rectosigmoid or whole colon), or plication, -pexy, and STARR techniques for evacuatory disorders secondary to obstructive anatomical features. Permanent stomas are an option of last resort.
ISSN:1521-6918
1532-1916
DOI:10.1016/j.bpg.2010.12.007