Die schwere idiopathische Obstipation Pathophysiologie, Diagnose und Therapie

Abstract

Zusammenfassung: Bei der schweren idiopathischen Obstipation (sogenannte ,,stow transit constipation") handelt es sich um eine seltene Erkrankung, die fast ausschlieglich bei Frauen in der dritten und vierten Lebensdekade angetroffen wird. Pathophysiologie und Jktiologie dieser Erkrankung sind nur zum Teil bekannt, wobei es sich h6chstwahrscheinlich um ein multifaktorielles Geschehen handelt. Abstract: Slow transit constipation is a rare condition almost exclusively encountered in middle-aged women. Pathophysiology and aetiology are poorly understood but a multi-factorial pathogenesis seems likely. With regard to differential diagnoses mechanical, drug induced, degenerative, metabolic, endocrinologic, neurologic and psychiatric causes of constipation must be excluded by an interdisciplinary approach. Gastrointestinal physiologic investigations including measurement of colonic transit ate mandatory. Furthermore, pangastrointestinal transit delay, pelvic floor dysfunction (outlet obstruction) and irritable bowel syndrome should be excluded. The initial mode of treatment is st¡ conservative. In cases of progression or persistence of symptoms surgical therapy should be offered. Subtotal co[ectomy with ileorectal anastomosis can be regarded as the standard operation for slow transit constipation. Postoperative complications include smal! bowel obstruc~Chirurgische Klinik und Poliklinik der Universit~it Wª (Direktor: Prof. Dr. A. Thiede).