Anatomy, physiology, and updates on the clinical management of constipation

Abstract

Clinical management of constipation has evolved from the prescription of dietary supplements, to potent stimulant laxatives, to corrective surgeries for organic blockage. Yet constipation does not respond to a one-size-fits-all treatment. In recent decades, the Bristol Stool Form Scale and Rome III diagnostic criteria have allowed for algorithmic diagnosis, yet these criteria could benefit from further extension and meaningful discussion. This review incorporates pertinent clinical updates and uses the anatomy and physiology of constipation as helpful signposts for the practicing clinician.

Bifidobacterium longum relieves constipation by regulating the intestinal barrier of mice

“…9 Meanwhile, a large number of studies have investigated the characteristics of the intestinal microbiota of constipated and healthy people. The consensus of these studies is that compared with that of healthy people, the intestinal microbiota of constipated patients showed a signifi-cant decrease in the number of beneficial bacteria, such as Bifidobacterium and Lactobacillus, and an increase in Bacteroidetes, 10,11 mainly in the number of Enterobacter, Enterococcus, Fusobacterium, etc. In addition, the altered metabolites of gut microbiota, such as methane, SCFAs, and bile acids, due to microbial dysfunction, are responsible for constipation.…”

Terapias utilizadas no tratamento da constipação intestinal primaria

“…O diagnóstico da constipação crônica diferenciando sintomas fisiológicos e patológicos casuais é feito para orientações quanto a aplicação de terapias não medicamentosas com alterações no estilo de vida, dieta, ingestão de líquidos, a prescrição de fármacos ou outras intervenções clínicas ou cirúrgicas (Dupont et al, 2020).…”

Anatomical and Physiological Characteristics of the Digestive Tract in Childhood

“…The evacuation process begins with the distension of the rectal ampulla that triggers a medullar reflex that consists of the contraction of the entire colon, aided by contractions of the diaphragm and abdominal wall, in addition to the relaxation of the perianal muscles located in the region of the pelvis floor and the anal sphincter. The control of conscious inhibition of this reflex and the evacuation act occurs after two years of age [28].…”