Surgical Interventions for Functional Constipation: An Update

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Colorectal Surgery

Background:

• Chronic idiopathic constipation (functional constipation) is difficult, infrequent defecation without a clear organic cause.
• While laxatives help most children, some require surgical assessment due to complications like fecal retention and rectal distension.
• Progressive constipation can impair normal colorectal motility, necessitating advanced interventions.

Purpose of the Study:

• To review surgical interventions for pediatric functional constipation.
• To provide guidance on selecting the optimal surgical procedure based on patient-specific evaluations.

Main Methods:

• Review of current surgical options for refractory functional constipation.
• Discussion of diagnostic tools influencing surgical decision-making: rectal biopsy, transit studies, contrast enema, manometry, and motility evaluation.

Main Results:

• Surgical interventions include intestinal diversion, antegrade enemas, sacral nerve stimulation, colonic resections, and Botulinum toxin injection.
• Patient evaluation data (biopsy, transit, imaging, manometry, motility) are crucial for procedure selection.

Conclusions:

• A subset of children with functional constipation benefits from surgical management.
• Tailoring surgical interventions based on comprehensive diagnostic evaluations is key to successful outcomes.