Gastro-intestinale chirurgie en gastro-enterologie. IX. Obstipatie: oorzaken en diagnostiek

- Constipation and disordered defaecation are symptoms, not disease entities. Usually these symptoms are not caused by organic abnormalities, but by disordered motility of the colon and pelvic floor.

- Both decreased colonic motility (inertia coli) and increased frequency and amplitude of haustrating colonic contractions in the context of an irritable bowel syndrome may lead to constipation. A third important functional cause of constipation is by paradoxical straining of the pelvic floor muscles during (attempts to) defaecate: anismus.

- In the diagnosis of constipation the primary aim usually is the exclusion of organic disorders. A plain abdominal X-ray and measurement of colonic transit with radiopaque particles will provide information about the severity of the constipation.

- Defaecography is indicated primarily if disordered faecal expulsion exists.

- Anorectal manometry is relevant when Hirschsprung's disease is suspected.