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Pelvic outlet obstruction.

Orit Kaidar-Person1, Seth A Rosen, Steven D Wexner

  • 1Department of Colorectal Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL 33331, USA.

Current Treatment Options in Gastroenterology
|July 13, 2005
PubMed
Summary
This summary is machine-generated.

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Constipation diagnosis requires a thorough history and physical exam to rule out organic causes. Treatment begins with conservative measures like fiber and fluids, with biofeedback and surgery reserved for specific cases.

Area of Science:

  • Gastroenterology
  • Colorectal Surgery

Background:

  • Constipation lacks a uniform definition, complicating diagnosis and treatment.
  • Pelvic outlet obstruction is a common cause of refractory constipation.
  • Constipation is often multifactorial, requiring a tailored therapeutic approach.

Purpose of the Study:

  • To outline a standardized diagnostic and therapeutic strategy for constipation.
  • To emphasize the importance of excluding organic causes early in evaluation.
  • To guide the selection of appropriate treatments based on constipation etiology.

Main Methods:

  • Comprehensive patient history and physical examination.
  • Exclusion of organic etiologies.
  • Utilizing diagnostic tests such as intestinal transit studies, anorectal manometry, defecography, balloon expulsion, and anal sphincter electromyography.

Related Experiment Videos

  • Implementing conservative treatments including fluid intake, dietary fiber, and laxatives.
  • Considering biofeedback training and surgical management for refractory cases.

    • Main Results:

    • A systematic diagnostic approach is crucial for effective constipation management.
    • Conservative measures form the cornerstone of initial treatment.
    • Biofeedback is beneficial for patients with paradoxical puborectalis contraction.
    • Surgery is a last resort for severe, intractable constipation.

    Conclusions:

    • A uniform diagnostic approach, starting with history and physical exam, is essential.
    • Conservative management should be the first line of treatment for most constipation cases.
    • Advanced therapies like biofeedback and surgery are indicated for specific patient subgroups with refractory symptoms.