Functional Constipation and Obstructed Defecation

Surg Clin North Am. 2024 Jun;104(3):565-578. doi: 10.1016/j.suc.2023.11.007. Epub 2023 Dec 14.

Abstract

Constipation encompasses symptoms of decreased colonic motility or difficulty with the defecation process. As a broad definition, this can be inclusive of functional constipation (FC) or colonic inertia, obstructed defecation (OD), and irritable bowel syndrome-constipation type (IBS-CS). After excluding IBS-C, FC and OD diagnosis and management require a multidisciplinary approach often involving nutritionists, pelvic floor therapists, urogynecologists, and colon and rectal surgeons. Differentiating the presence or absence of each can direct therapy and prognosticate chances for improvement in this often complex combination of disorders.

Keywords: Anismus; Functional constipation; Non-relaxing puborectalis; Non-relaxing sphincter; Obstructed defecation; Pelvic floor dysfunction; Pelvic outlet obstruction; Slow transit colonic inertia.

MeSH terms

  • Constipation* / diagnosis
  • Constipation* / etiology
  • Constipation* / physiopathology
  • Constipation* / therapy
  • Defecation* / physiology
  • Humans
  • Intestinal Obstruction / diagnosis
  • Intestinal Obstruction / etiology
  • Intestinal Obstruction / physiopathology
  • Irritable Bowel Syndrome / complications
  • Irritable Bowel Syndrome / diagnosis
  • Irritable Bowel Syndrome / physiopathology