The surgical treatment of chronic constipation

Constipation rarely requires surgical treatment. The common causes are degenerative neurological disease, impaired rectal evacuation and functional bowel disease with features of the irritable bowel syndrome. Psychogenic factors should be investigated and any underlying bowel condition identified. The role of anorectal physiology is discussed. The results of surgical resection for slow transit constipation are poor unless patients are carefully selected. Anismus is difficult to treat successfully by surgery. Recently, colonic conduit has been proposed for obstructed defaecation.