Constipation: How does it exist?

Background: Functional defecation disorders are common and affect approximately 50% of patients with chronic constipation. The etiology of functional defecation disorders is not well known, but several pathophysiologic mechanisms have been described, including failure of rectoanal coordination, paradoxical anal contraction or insufficient relaxation of anal sphincter during defecation and impairment of rectal sensation as well as secondary slowing of colonic transit. Aim of this manuscript is to review the pathogenesis and surgical treatment of constipation. Method: An extensive Medline search, textbooks, scientific reports and scientific journals are the data sources. We also reviewed reference lists in all articles retrieved in the search as well as those of major texts regarding pathogenesis and surgical treatment of constipation. Results: There are many studies about the pathogenesis and pathophysiology of constipation. Also there are many medical and surgical treatment strategies were developed. Conclusion: The patients with constipation symptom must be evaluated carefully, and medical treatment must be tried after differential diagnosis is made. Only in patients that do not respond to the medical, surgical treatment can be considered.