When is surgical treatment indicated in constipation?

Updated: Jul 05, 2019
  • Author: Marc D Basson, MD, PhD, MBA, FACS; Chief Editor: BS Anand, MD  more...
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Answer

Surgery may occasionally play a role in the management of rectal outlet obstruction (eg, rectocele, rectal prolapse, internal rectal intussusception) or in patients with a hypomotile (laxative) colon that is refractory to medical treatment.

In the former case, treatment is directed at the cause of the outlet obstruction. In the latter case, total abdominal colectomy may be indicated; the operation may be less morbid if performed laparoscopically. [39, 40] In both cases, thorough preoperative evaluation is essential to rule out other medically treatable causes or potentiating factors.

These patients may also have an underlying psychological cause for their ailment, and addressing this is important before irreversible surgical interventions are contemplated.


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