Constipation: Diagnosis and Investigation

DeckerMed Surgery ◽

10.2310/surg.2385 ◽

2018 ◽

Author(s):

Charles H Knowles

Keyword(s):

Key Words ◽

Surgical Management ◽

Clinical Evaluation ◽

Chronic Constipation ◽

Background Knowledge ◽

Practical Approach ◽

Slow Transit ◽

Defecation Disorder

Although constipation is no longer treated primarily with surgery, surgeons continue to regularly see patients with constipation in ward and ambulatory settings. It is therefore critical that surgeons have a practical approach to the patient with constipation in respect of diagnosis, investigation, and management. This review covers background knowledge in terms of the definition, classification, epidemiology, and etiology of constipation. It then addresses the clinical evaluation and investigation of the patient with chronic constipation. A subsequent review follows on to cover medical and surgical management. This review contains 6 figures, 8 tables and 59 references Key Words: chronic constipation, constipation, defecation disorder, defecography, dyssynergia, intussusception, manometry, proctography, rectocele, slow-transit

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Prevalence and Clinical Characteristics of Dyssynergic Defecation and Slow Transit Constipation in Patients with Chronic Constipation

Journal of Clinical Medicine ◽

10.3390/jcm10092027 ◽

2021 ◽

Vol 10 (9) ◽

pp. 2027

Author(s):

Samuel Tanner ◽

Ahson Chaudhry ◽

Navneet Goraya ◽

Rohan Badlani ◽

Asad Jehangir ◽

...

Keyword(s):

Medical History ◽

Chronic Constipation ◽

Clinical Characteristics ◽

Anorectal Function ◽

Slow Transit Constipation ◽

Dyssynergic Defecation ◽

Patient Demographics ◽

Balloon Expulsion ◽

Slow Transit ◽

Transit Constipation

Patients with chronic constipation who do not respond to initial treatments often need further evaluation for dyssynergic defecation (DD) and slow transit constipation (STC). The aims of this study are to characterize the prevalence of DD and STC in patients referred to a motility center with chronic constipation and correlate diagnoses of DD and STC to patient demographics, medical history, and symptoms. High-resolution ARM (HR-ARM), balloon expulsion testing (BET) and whole gut transit scintigraphy (WGTS) of consecutive patients with chronic constipation were reviewed. Patients completed questionnaires describing their medical history and symptoms at the time of testing. A total of 230 patients completed HR-ARM, BET, and WGTS. Fifty (22%) patients had DD, and 127 (55%) patients had STC. Thirty patients (13%) had both DD and STC. There were no symptoms that were suggestive of STC vs. DD; however, patients with STC and DD reported more severe constipation than patients with normal transit and anorectal function. Patients with chronic constipation often need evaluation for both DD and STC to better understand their pathophysiology of symptoms and help direct treatment.

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Clinical Evaluation of Neurosensory Changes in the Infraorbital Nerve Following Surgical Management of Zygomatico-Maxillary Complex Fractures

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2015/16511.7008 ◽

2015 ◽

Cited By ~ 1

Author(s):

Asish Kumar Das

Keyword(s):

Surgical Management ◽

Clinical Evaluation ◽

Infraorbital Nerve ◽

Complex Fractures

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Constipation: Medical and Surgical Treatment

DeckerMed Surgery ◽

10.2310/surg.2386 ◽

2018 ◽

Author(s):

Charles H Knowles

Keyword(s):

Pelvic Floor ◽

Surgical Management ◽

Surgical Intervention ◽

Radical Surgery ◽

Rectal Resection ◽

Benefit Analysis ◽

Rectal Excision ◽

Stapled Transanal Rectal Resection ◽

Slow Transit ◽

Risk Benefit Analysis

This review follows the general review entitled “Constipation,” which introduced the definition, classification, epidemiology, etiology, clinical evaluation, and investigation of constipation. This review addresses the medical and surgical management of constipation with a focus on surgical management. The latter is a subject of much controversy, and this review aims to provide a balanced view between those who favor radical surgery for the colon (colectomy) and rectum/pelvic floor (forms of rectopexy, rectal excision, and reinforcement) and those who have concerns that the unpredictable outcomes of such procedures push the risk–benefit analysis against surgical intervention for most patients. This review contains 5 figures, 2 tables and 80 references Key Words: chronic constipation, colectomy, constipation, ileorectal, intussusception, pelvic floor, rectocele, rectocele repair, rectopexy, slow-transit, stapled transanal rectal resection

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Phase II Clinical Evaluation of SP-304, a Guanylate Cyclase-C Agonist, for Treatment of Chronic Constipation

The American Journal of Gastroenterology ◽

10.14309/00000434-201010001-01322 ◽

2010 ◽

Vol 105 ◽

pp. S487-S488 ◽

Cited By ~ 8

Author(s):

Kunwar Shailubhai ◽

Craig Talluto ◽

Stephen Comiskey ◽

John Foss ◽

Alan Joslyn ◽

...

Keyword(s):

Phase Ii ◽

Clinical Evaluation ◽

Guanylate Cyclase ◽

Chronic Constipation ◽

Guanylate Cyclase C

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Idiopathic Pruritus Ani and Acute Perianal Dermatitis

Clinics in Colon and Rectal Surgery ◽

10.1055/s-0039-1687827 ◽

2019 ◽

Vol 32 (05) ◽

pp. 327-332

Author(s):

Adrián E. Ortega ◽

Xavier Delgadillo

Keyword(s):

Clinical Evaluation ◽

Practical Approach ◽

Pruritus Ani ◽

Perianal Dermatitis

AbstractThis article reviews the etiologies, pathophysiology, clinical evaluation, and treatment of idiopathic pruritus ani and perianal dermatitis. It underscores a practical approach to each of these common proctologic conditions.

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