Constipation

Maher A. Abbas, MD
Compassion, Excellence, Integrity

Diplomate, American Board of Surgery

Diplomate, American Board of Colon and Rectal Surgery

Fellow, American College of Surgeons

Fellow, American Society of Colon and Rectal Surgeons

“The best interest of the patient is the only interest to be considered…”W.J. Mayo, MD (Founder of the Mayo Clinic)

 

Dr. Maher Abbas is an American Board Certified Colon and Rectal Surgeon who performs the latest and most advanced procedures to treat conditions affecting the small intestine, colon, rectum, and anus.  He is a leader in minimally invasive and endoscopic surgery. With over 15,000 operations and procedures experience, he provides state of the art treatment to his patients.

 

What is constipation?

Constipation is the infrequent or difficult passage of stool.  It is generally described as having fewer than 3 bowel movements a week, prolonged straining to evacuate stools, incomplete emptying, and/or the passage of hard stools.  Causes of constipation include proctologic disorders such as anal fissure, thyroid or parathyroid hormone disease, diabetes, pregnancy, neurologic conditions that affect the muscles of the colon and rectum (Parkinson’s disease, multiple sclerosis, stroke), and weakened pelvic floor muscles.  Less commonly are serious conditions such as bowel obstruction from cancer.  By far, the most common causes of constipation are lifestyle related including lack of physical activity, poor diet, and low water intake.   Constipation can lead to abdominal pain with bloating, colon inflammation (diverticulitis), and proctologic disorders such as hemorrhoids and fissure.

How is constipation evaluated?

 

Dr. Maher Abbas will assess your symptoms and perform a physical examination to determine the type of testing needed.  For some patients no testing is needed.  Yet for others, 1 or more of the following tests is ordered to assess constipation:

  • Blood test for thyroid hormones and calcium level

  • Endoscopic examination of the colon and rectum like Flexible Sigmoidoscopy and Colonoscopy

  • Anorectal Manometry test to evaluate the anal sphincter muscle function and relaxation

  • Colonic transit study to check for colon function. In this procedure, you swallow a capsule that contains small ring markers which travel through the intestine.  XRAY films are obtained 3 and 5 days later to assess how fast these markers travel through the colon

  • Dynamic MRI (magnetic resonance imaging) defecography to check for pelvic floor function. During this procedure, contrast gel is inserted into the rectum and in some cases the vagina.  MRI pictures are obtained at rest and while you try to defecate to visualize what happens with the internal pelvic organs.

How is constipation treated?

Most patients with constipation are treated medically.  Surgery is reserved for severe cases of constipation with a lazy colon or for pelvic floor conditions such as rectocele or rectal prolapse.    For a more comprehensive list of constipation therapy, check Constipation.

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