Surgery for slow transit constipation: are we helping patients?

Abstract

Surgery for constipation is not perfect, and preoperative symptoms may persist after surgery. When assessing long-term quality of life, the mental component of the SF-36 was low compared with the general population, and the physical component was similar. Moreover, because 77% report long-term improvement, surgery is beneficial for appropriate patients.

Confecção de válvulas biológicas (seromiotomias) para controle de diarréia intratável após colectomia total por inércia colônica

“…Remember that the association between inflammatory bowel disease and colonic inertia can occur. The distinction between them should always be made following the criteria of Rome III 15 .…”

“…Aiming to solve the problem in a more physiological way, seromyotomies have been proposed for the preparation of this patient, following the principles proposed by Lázaro da Silva (1991) in the making of perineal colostomy 15 . This procedure results in slight fibrotic ring without stenosis of the gut lumen, but a braking mechanism that is responsible for the continence 2,5,6,11,14 .…”

Postoperative course and long term follow up after colectomy for slow transit constipation – is surgery an appropriate approach?

“…Incontinence and diarrhoea occurred in up to 52% and 46% of patients, respectively. Long term studies revealed conflicting results [12,13,[21][22][23]. One analysis noted that after surgery, 20% of the patients still used laxatives, enemas or suppositories to enable defecation [9].…”

Acupuncture in Treatment of Chronic Functional Constipation

“…Their sideeffects make the symptoms complicated and challenging. When cathartic and other conservative measures fail, invasive treatment options are considered, including antegrade colonic enemas [16], sacral nerve stimulation [17], or subtotal colectomy to relieve the severe symptoms [18], and sometimes a stoma creation. Surgical excision of the colon can be successful in 50-75% of patients, but abdominal pain and constipation can reoccur and patients also run a risk of developing a post-operative small bowel obstruction or faecal urgency/incontinence [19].…”