Are there surgeries that can resolve my constipation?
Surgery is always a last resort. Most constipation can be resolved with diet,
lifestyle changes and laxative therapy. Surgery is recommended if you have a
slow moving colon that has failed all medical treatments or if you have a structure
blocking the way that is causing your constipation. Structures blocking the way of
stool moving through the anal canal can also be lifted by strengthening the pelvic
floor through physical therapy.
How can physical therapy help constipation?
If the muscles of the pelvic floor are not working properly, then physical therapy
(PT) will help to retrain those muscles. We are not used to having to think about
muscles of the pelvic floor. PT assists you in connecting the mind and body to
enable these muscles to work properly when having a bowel movement. PT can
also help with strengthening muscles and to decrease spasm.
What testing is appropriate to evaluate constipation?
There are a variety of tests for constipation offered at the University of Michigan
Medical Procedures Unit. Testing may include a colonoscopy, anal-rectal
manometrics, the Smart pill wireless motility capsule or defecography. These are
specialized tests that evaluate the colon for any structural problems or problems
with muscle function that may be contributing to constipation.
Are there different types of constipation?
There are four types of constipation:
* Diet and Medication Controlled Constipation: The colon moves stool along within 24 -72 hours. The muscles of the pelvic floor move properly. Usually, most people respond to fiber or laxative treatment.
* Dysynergic Constipation:The muscles of the pelvic floor do not work properly and may even perform the opposite function of what they are supposed to do. Sometimes muscles are in spasm. Patients usually complain of not being able to fully empty or having to use their fingers to pass stool. Dysynergic constipation may be coupled with an outlet obstruction. An outlet obstruction is where a structure such as a rectocele or enterocele is in the way of stool coming out.
* Slow Transit Constipation: The colon moves slowly, as a result, bowels move very infrequently sometimes only once every 2-3 weeks.
* Combined dysynergic and slow transit constipation.