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The evaluation and treatment of functional constipation
R M Mollen1, A T Claassen, J H Kuijpers
1Dept. of Surgery, University Hospital Nijmegen, The Netherlands.
Scandinavian Journal of Gastroenterology. Supplement
|January 1, 1997
Summary
Functional constipation, often a taboo topic, can be diagnosed using colorectal laboratory tests. These tests help identify causes like slow transit constipation or pelvic floor dysfunction for effective management.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Physiology
Background:
- Constipation and defecation are often considered taboo subjects, leading to underreporting and underdiagnosis.
- The inability to defecate or reliance on digital evacuation highlights significant functional impairments.
- Advancements in colorectal laboratory testing have enabled detailed functional assessments of the colon and continence mechanisms.
Purpose of the Study:
- To present a comprehensive overview of the assessment and management of functional constipation.
- To highlight the utility of various diagnostic procedures in understanding colonic function and continence.
- To differentiate between various causes of functional constipation for targeted treatment.
Main Methods:
- Transit studies to assess colonic transit time.
- Defecography to evaluate anorectal function and pelvic floor dynamics.
- Electromyography (EMG) to assess pelvic floor muscle activity.
- Anal manometry to measure anal sphincter pressures and rectal sensation.
Main Results:
- These diagnostic procedures are crucial for evaluating patients with functional constipation.
- Identified causes include slow transit constipation (colonic inertia), spastic pelvic floor syndrome, rectocele, and intussusception.
- A systematic approach using these tests aids in accurate diagnosis.
Conclusions:
- Functional constipation encompasses diverse etiologies requiring specific diagnostic approaches.
- Colorectal laboratory tests provide essential insights into the pathophysiology of constipation.
- Effective management strategies are guided by precise diagnosis of the underlying cause.