Constipation

Modern Management ◽

Slow Transit ◽

Transit Constipation ◽

Evacuation Disorder

This review presents an overview of the management of constipation. The review addresses the diagnosis of primary and secondary forms and then discusses in greater detail the investigative workup and modern management of chronic constipation (primary). The review addresses what simple and more advanced investigations are relevant for determining pathophysiology and gives an overview of treatment options, including pharmacologic, behavioral, and surgical approaches for thus defined subgroups of patients (evacuation disorder, slow transit constipation). This review contains 3 figures, 6 tables, and 89 references.

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 ◽

Dyssynergic Defecation ◽

Patient Demographics ◽

Balloon Expulsion ◽

Slow Transit ◽

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.

Neuropeptides in idiopathic chronic constipation (slow transit constipation)

Neurogastroenterology & Motility ◽

10.1046/j.1365-2982.1997.d01-46.x ◽

1997 ◽

Vol 9 (3) ◽

pp. 143-150 ◽

Cited By ~ 66

Author(s):

K. Sjölund ◽

S. Fasth ◽

R. Ekman ◽

L. Hultén ◽

H. Jiborn ◽

...

Keyword(s):

Chronic Constipation ◽

Slow Transit ◽

Antiperistaltic Side-to-Side Ileorectal Anastomosis Is Associated with a Better Short-Term Fecal Continence and Quality of Life in Slow Transit Constipation Patients

Digestive Surgery ◽

10.1159/000437234 ◽

2015 ◽

Vol 32 (5) ◽

pp. 367-374 ◽

Cited By ~ 7

Author(s):

Wei Chen ◽

C.-Qing Jiang ◽

Qun Qian ◽

Zao Ding ◽

Zhi-Su Liu

Keyword(s):

Quality Of Life ◽

Ileorectal Anastomosis ◽

Cleveland Clinic ◽

Patient Characteristics ◽

Surgical Approaches ◽

Slow Transit ◽

Background: Surgical treatment of refractory slow transit constipation (STC) is traditionally performed using end-to-side ileorectal anastomosis (SE-IRA) with total abdominal colectomy (TAC). Antiperistaltic side-to-side (SS) IRA is suggested to be a superior approach. Employing a well-characterized cohort of STC patients, we compared the postoperative outcomes of the 2 surgical approaches. Methods: A total of 42 patients underwent TAC for refractory idiopathic STC. Twenty patients were treated using traditional SE-IRA whereas 22 patients were treated using SS-IRA. Patients were evaluated at 3 and 6 months as well as at 1 and 2 years after surgery. Both groups were compared for patient characteristics, perioperative data and quality of life. Cleveland Clinic Incontinence Score (CCIS) and Gastrointestinal Quality of Life Index (GQILI) were adopted for evaluating postoperative recovery. Results: Both study groups were comparable with respect to general patient characteristics, disease severity and post-operative complications. Fewer than 30% of all patients reported substantial dissatisfaction with surgical outcomes in both the groups. The SS-IRA group was associated with a lower postoperative CCIS (p < 0.05) and a better GQILI (p < 0.05) than that of the SE-IRA group during early follow-up examinations. Conclusion: In this study, SS-IRA was superior to traditional SE-IRA for the treatment of STC with respect to post-operative outcomes, and especially during early follow-up.

Chronic constipation: modern view on the problem. A review

General Surgery ◽

10.30978/gs-2021-1-67 ◽

2021 ◽

Author(s):

I. M. Leshchyshyn ◽

Y. M. Susak ◽

O. I. Okhots’ka ◽

P. L. Byk ◽

L. Y. Markulan ◽

...

Keyword(s):

Quality Of Life ◽

Surgical Treatment ◽

Chronic Constipation ◽

Treatment Method ◽

Adequate Treatment ◽

Wide Range ◽

Slow Transit ◽

Chronic constipation is a frequently diagnosed heterogeneous pathology that significantly impairs the quality of life in all population groups and its frequency increases with age. It commonly affects up to 10 — 15 % of the population. There are numerous classifications of constipation due to a great number of disorders that cause it. The types of constipation are identified based on the etiology or mechanism of its development. Different criteria are used to specify the categorization of constipation, but it is still difficult to find one general classification including all types of constipation. The Rome IV criteria categorize disorders of chronic constipation into four subgroups. The treatment depends on the subtype. The significant increase of constipation cases is observed nowadays. This disorder is facilitated by a sedentary lifestyle, insufficient amount of fiber and fluid in the diet, a wide range of diseases that directly lead to the development of chronic constipation, congenital and acquired pathologies, abnormal intake of laxatives and opioids or a combination of these factors. Despite numerous publications on slow transit constipation, the latter is still the subject of research for many specialists. A lot of recent scientific works have been dedicated to the immunohistochemical studies of interstitial pacemaker cells. The numbers of markers they express were found. Consequently, the investigations of modern scientists are aimed to develop and implement new laboratory methods for determining the indications for surgical treatment depending on a diagnosed disorder of the intestinal neurophysiology. These methods will ensure a differentiated selection of patients for surgical treatment. The step approach to the diagnosis of chronic constipation allows choosing an adequate treatment method in order to improve symptoms, the quality of life, and patient satisfaction. The literature review indicates that surgery still remains the most radical treatment method for patients with slow transit constipation.

Severe chronic constipation of young women: 'idiopathic slow transit constipation'.

Gut ◽

10.1136/gut.27.1.41 ◽

1986 ◽

Vol 27 (1) ◽

pp. 41-48 ◽

Cited By ~ 293

Author(s):

D M Preston ◽

J E Lennard-Jones

Keyword(s):

Young Women ◽

Chronic Constipation ◽

Slow Transit ◽

Severe Chronic Constipation ◽

Decreased TRK C may reflect developmental abnormalities in Hirschsprung's disease and idiopathic slow transit constipation

Gastroenterology ◽

10.1016/s0016-5085(01)80111-6 ◽

2001 ◽

Vol 120 (5) ◽

pp. A23-A23

Author(s):

P FACER ◽

C KNOWLES ◽

P THOMAS ◽

P TAM ◽

N WILLIAMS ◽

...

Keyword(s):

Hirschsprung's Disease ◽

Hirschsprung’S Disease ◽

Developmental Abnormalities ◽

Slow Transit ◽

Autoimmune encephalitis and gastrointestinal dysmotility: achalasia, gastroparesis, and slow transit constipation

Zeitschrift für Gastroenterologie ◽

10.1055/a-1233-2190 ◽

2020 ◽

Vol 58 (10) ◽

pp. 975-981

Author(s):

Thomas Frieling ◽

Christian Kreysel ◽

Michael Blank ◽

Dorothee Müller ◽

Ilka Melchior ◽

...

Keyword(s):

Interstitial Cells Of Cajal ◽

Autoimmune Encephalitis ◽

Enteric Neurons ◽

Gastrointestinal Dysmotility ◽

Slow Transit ◽

Small Intestinal ◽

Interdigestive Motility ◽

Cells Of Cajal ◽

Abstract Background Neurological autoimmune disorders (NAD) are caused by autoimmune inflammation triggered by specific antibody subtypes. NAD may disturb the gut-brain axis at several levels including brain, spinal cord, peripheral, or enteric nervous system. Case report We present a case with antinuclear neuronal Hu (ANNA-1)- and antiglial nuclear (SOX-1) autoimmune antibody-positive limbic encephalitis and significant gastrointestinal dysmotility consisting of achalasia type II, gastroparesis, altered small intestinal interdigestive motility, and severe slow transit constipation. The autoantibodies of the patient’s serum labeled enteric neurons and interstitial cells of Cajal but no other cells in the gut wall. Achalasia was treated successfully by pneumatic cardia dilation and gastrointestinal dysmotility successfully with prucalopride. Conclusion NAD may disturb gastrointestinal motility by altering various levels of the gut-brain axis.