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Constipation. Pathogenesis and management
1Department of Surgery and Research, Faculty of Medicine, Cairo University, Egypt.
Drugs
|April 1, 1993
Summary
Chronic idiopathic constipation (CIC) involves colonic or anorectal dysmotility. Treatment options for this functional bowel disorder range from medication and biofeedback to surgery, with careful consideration of laxative side effects.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Physiology
Background:
- Constipation is a complex condition with varied causes, including functional disorders like chronic idiopathic constipation (CIC).
- CIC can stem from colonic or anorectal dysmotility, such as rectal inertia or outlet obstruction.
- Outlet obstruction, characterized by excessive straining with soft stools (strainodynia), has identifiable subtypes.
Purpose of the Study:
- To explore the pathophysiology of chronic idiopathic constipation (CIC).
- To review diagnostic methods for anorectal dysmotility.
- To discuss current and potential treatment strategies for CIC.
Main Methods:
- Review of literature on constipation, anorectal function, and treatment modalities.
- Discussion of diagnostic tools including faecoflowmetry, water enema tests, and reflexometry.
- Analysis of surgical and medical interventions for CIC.
Main Results:
- Anorectal dysmotility, including rectal inertia and outlet obstruction, is a key factor in CIC.
- The rectosigmoid junction (RSJ) is identified as a potential pacemaker for rectal motility.
- New diagnostic methods like faecoflowmetry aid in assessing anorectal function.
Conclusions:
- Treatment for CIC remains challenging, with pharmacological options preferred initially.
- Biofeedback shows promise for outlet obstruction constipation.
- Surgical interventions have variable outcomes, and laxative abuse can lead to adverse effects.