Chronische Obstipation und Stuhlentleerungsstörung – Diagnostik und Therapie aus Sicht des Chirurgen

Chronic constipation with defecation disorder is a frequent illness, the incidence of which increases with age. The symptoms can usually be easily limited through an anamnesis and clinical proctological examinations. The most important additional examination is endoscopy to rule out organic diseases. The treatment is always primarily conservative with bowel movement regulation, defecation aids and laxatives. The goal is to normalize bowel emptying. A permanent cure is practically impossible if there is a functional disorder. All measures to regulate bowel movements must be continued for life if symptoms arise. An attempt at treatment with physiotherapy as well as biofeedback treatment makes sense. Anal irrigation is a very promising treatment concept. After conservative measures have been exhausted, surgery can be performed to correct morphological and structural changes; however, correction does not always lead to an improvement in the clinical symptoms, therefore the indications for surgical interventions should be made very cautiously.