Surgical Management of Constipation

Question 1

When should surgery be used for constipation of dysmobility?

Answer 1

As a last resort to try and improve QOL

Question 2

What are the three surgical methods for constipation?

Answer 2

1. **Colectomy with ileo anal resection - **Remove large bowel but need to make sure the sphincters are not weak and that the problem is in the large bowel. often causes abdo pain and bloating
2. Sacral nerve stimulation - Stimulate peristalsis via the sacral nerve
3. ACE (anterograde colonic enema) - Not a cure but has catheter to cecum to flush out faeces.

Question 3

What must be excluded before ileoanal resection?

Answer 3

Weak sphincters

Defocation disorders

Question 4

What may be carried out before a colectomy and why?

Answer 4

Ileostomy to check small bowel workds and an emotional step..

Question 5

How do you treat obstructive defocation syndrome?

Answer 5

Intussception repair

Rectocele repair