$Unique_ID{BRK01374} $Pretitle{} $Title{Surgery for Constipation} $Subject{digestion constipation surgery digestive system laxative diuretics antidepressants antacids barium enema proctosigmoidoscopy colorectal transit study intestine intestines colon constipated laxatives diuretic antidepressant antacid enemas} $Volume{I-12} $Log{} Copyright (c) 1991-92,1993 Tribune Media Services, Inc. Surgery for Constipation ------------------------------------------------------------------------------ QUESTION: I have been bothered with chronic constipation for most of my life, but nothing like a long time friend. He has been to just about every doctor in town, and is now being told that perhaps surgery is the only way out for him. I am afraid he has fallen into the wrong hands and want to know if there is ever any indication for surgery in someone who suffers from constipation? Please help us. ------------------------------------------------------------------------------ ANSWER: Constipation is a most common problem, and results in an estimated 2.5 million visits to the doctor's office each year. And that doesn't take into account all the people who are treating themselves with over-the-counter laxative preparations that may cost as much as $400 million each year. It may affect people of all ages, although it is seen much more frequently in people over the age of 65 and affects women from two to three times more often than men. Because constipation is a symptom rather than a disease in and of itself, it must be carefully evaluated before medications and treatment can be properly recommended. The list of possible causes for constipation is a long one indeed, and includes drug effects resulting from diuretics, antidepressants, and even over use of antacids. Diseases of the nervous system such as Parkinson's disease and multiple sclerosis as well as metabolic disease like diabetes can be the at the root of the problem. Of course diet plays an important role, and insufficient fiber in the diet may be the predisposing cause. The tests to determine the origin of the problem are therefore numerous and include barium enema and proctosigmoidoscopy, both of which help the physician to evaluate the condition. A test called the "colorectal transit study" helps determine if the waste products move through the bowel in the proper manner and time. For this test the patient swallows material or "markers" which are easily seen on x-ray, as many as twenty markers being used during the course of a study, and abdominal x-rays are taken each day for as many as 7 days, or until all the markers have been passed. Surgical treatment may be considered for selected patients in which there is a disabling slow transit time, and where medical treatment has not been effective. Such a decision must be made with great caution, as experience with this type of surgery is still limited, and the results have been quite variable and inconsistent. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.