[Three variants of pathogenesis and therapy of chronic constipation]

Constipation--is a frequent clinical syndrome, which occurs in approximately 15-25% of population. Investigations carried out during the last decade have contributed to a better understanding of the basic mechanisms of chronic constipation (CC), in particular its relationship to colonic transit and anorectal function. All possible causes affecting the occurance of constipation (methabolic, deficiency of fiber, medicines) should be taken into consideration at the patient's examination and anorectal pathology should be excluded. Functional chronic constipation consists of three subtypes: slow transit constipation, dyssynergetic defecation and IBS with predominance of constipation. Rome criteria are useful guidelines for diagnosis of functional constipation. Treatment should be based on evidence-based diagnosis of CC variants. Treatment of an inert colon should be based on enterokinetic type prucalopride and lubiprostone. The possibilities of biophydbectherapy should obligatory be used in dyssynergetic defecation treatment.