Strictly speaking constipation is a symptom rather than a disease itself.

 It is however so common and in most cases is just utterly miserable but in some cases it can lead to severe consequences that we have given it a section of this website.

There are a multitude of diseases, drugs and conditions that can give rise to constipation and it is important to investigate according to symptoms which mean, in most cases, a visit to see your family doctor.

• Slow transit constipation
• IBS (Irritable Bowel Syndrome) - constipation predominant
• Medication
• Immobility

Obstructed Defaecation Syndrome (ODS)

   Characterised by a normal urge to defaecate but an impaired ability to expel the faecal bolus

The symptom complex includes

• Repeated unsuccessful attempts at defaecation
• Straining
• Rectal bleeding
• Digitation to aid evacuation
• Laxatives/enema use
• Perineal and lower abdominal pain

 It is often associated with a rectocele and internal rectal prolapse/rectal intussusception

Investigations

• Whole colon test - Colonoscopy/Barium enema
• Routine blood tests
• Defaecating proctogram
• +/- anorectal physiology
• +/- endoanal ultrasound
• +/- colonic transit studies

Management

• Biofeedback therapy
• Novel Surgical technique: STARR (Stapled TransAnal Rectal Resection)
  • Based on the stapled haemorrhoidopexy procedure
  • Full thickness rectal resection with simultaneous anastomosis
  • Restores bowel continuity using two 33mm circular staplers