Περίληψη:
Constipation is a subjective symptom of various pathological conditions.
Incidence of constipation fluctuates from 2 to 30% in the general
population. Approximately 50% of constipated patients referred to
tertiary care centers have obstructed defecation constipation.
Constipation of obstructed defecation may be due to mechanical causes or
functional disorders of the anorectal region. Mechanical causes are
related to morphological abnormalities of the anorectum (megarectum,
rectal prolapse, rectocele, enterocele, neoplasms, stenosis). Functional
disorders are associated with neurological disorders and dysfunction of
the pelvic floor muscles or anorectal muscles (anismus, descending
perineum syndrome, Hirschsprung’s disease). However, this type of
constipation should be differentiated by colonic slow transit
constipation which, if coexists, should be managed to a second time.
Assessment of patients with severe constipation includes a good history,
physical examination and specialized investigations (colonic transit
time, anorectal manometry, rectal balloon expulsion test, defecography,
electromyography), which contribute to the diagnosis and the
differential diagnosis of the cause of the obstructed defecation.
Thereby, constipated patients can be given appropriate treatment for
their problem, which may be conservative (bulk agents, high-fiber diet
or laxatives), biofeedback training or surgery. (C) 2005 Blackwell
Publishing Asia Pty Ltd.
Συγγραφείς:
Andromanakos, N
Skandalakis, P
Troupis, T
Filippou, D
