[Pathogenetic treatment for chronic constipation]

The investigations conducted in the past decade have offered better insight into the basic mechanisms of chronic constipation (CC), among other things, its association with large bowel (LB) transit and anorectal function. Intestinal dyskinesia, slow transit of the intestinal contents (inert LB), and impaired defecation due to pelvic floor dyssynergia play a leading role in the pathogenesis of primary constipation. Its treatment should be similar to that for CC. Motility regulators correcting LB dyskinesia are given to treat functional constipation and constipation-predominant irritable bowel syndrome. Enteral pro-kinetic agents are effective in treating the inert LB. The possibilities of biofeedback therapy should be used to treat dyssynergic defecation.