Surgical management of severe constipation due to slow transit and obstructed defecation syndrome

Chronic constipation is a common frustrating condition. It is classified according to symptoms, physical exam, and diagnostic testing into three categories: slow colonic transit, obstructed defecation, and a combination of these two entities. Each category has different treatment algorithms, but medical therapy including dietary changes and biofeedback training (for obstructed defecation) should always be tried first. If appropriate medical therapy fails, several surgical options could be considered, though data regarding their efficacy is mixed.