Surgical Intervention
- A surgical referral may be considered for treatment of constipation if patient is unresponsive after prolonged trial of nonsurgical measures and if symptoms affect activities of daily living
- Effective in relieving constipation is a subtotal colectomy with ileorectostomy with a laparoscopic colectomy obtaining similar success rate but less morbidity than an open colectomy
- A rectovaginal repair or rectal suspension may be considered for a rectocele or rectal prolapse
- Patients with functional constipation should have a formal psychiatric and upper gastrointestinal motility evaluation with small intestine transit time measurement before undergoing surgery