[Constipation: drug or surgical treatment?]

Constipation is a very frequent symptom. It affects 7-10% of people. Otherwise a severe constipation exists which is rare, but extremely serious with evacuations every 15 days to 2 months. We expose the classification of constipation in its types: colonic, rectal and anal. We analyse the diagnostic trial which has to be started with a careful anamnesis and well directed physical examination. Laboratory tests and instrumental investigations will be essential means to define exactly the type of constipation and its pathogenetic mechanism. We go deep into physical involvement of constipation and into the problem of constipation in the elderly: except for particular groups (women suffering from colonic hypokinetic constipation) the age of patient is usually old. Medical treatment is described especially regarding the type of constipation. At last we review the surgical techniques proposed for every form of constipation, with exposure and interpretation of their results.