Surgical Treatment for Chronic Constipation

Most people in India suffer from constipation in one form or another, although it is not commonly talked about. Indian medical studies show that while most Indians tend to ignore this nagging problem, the problem can get really severe if left untreated for a long time. Recent studies prove that almost 16 percent of women in India exhibit symptoms of chronic constipation. Typically, constipation hinders normal bowel movements, and its symptoms include irregular bowel habits, frequent use of laxatives, strained defecation, or incomplete defecation. Find out about causes, treatment and prevention of constipation on this link.

Constipation is treated by lifestyle modifications and treatment of the cause of the constipations but surgical resection of redundant colon and rarely Colectomy (surgical removal of the colon) may be advised for severe symptoms caused by colonic inertia. However, the benefits of this surgery must be weighed against possible complications.

A condition known as Obstructed defecation syndrome or ODS is a chronic defecation disorder that affects thousands of Indians, especially the women. In case of women in India, this defecation disorder is attributable to the general weakness in the pelvic support structures. In case of ODS, usually the lining of the rectum juts out during bowel movements, which severely obstructs the passing of stool. According to the latest medical research, about 45 percent of individuals suffering from ODS have reported having the condition for at least five years if not more.

How can individuals find out if they have chronic constipation/ODS?

A medical study claimed that 37 percent of women who met all the symptom criteria for chronic constipation were not even aware that they had constipation or ODS. Here is a quick checklist to determine if a person is suffering from chronic constipation or ODS.

• Weekly bowel movements amount to fewer than three
• Strained defecation in at least 25 percent of the instances
• A feeling of incomplete defecation at least 25 percent of the instances
• Hard stools at least 25 percent of the instances.

If a person has experienced two or more of the above conditions for more than three months, it is highly likely that the person is suffering from chronic constipation or ODS, and needs a surgical remedy. The good news is that a surgical solution is available now for women suffering from ODS.

Before making any decisions about surgery, medical practitioners use a diagnostic test known as Defecography to study the changes in the rectal and anal canals during bowel movements in a patient. This test can accurately assess the defecation disorders not ordinarily evident in a colonoscopy or sigmoidoscopy.

The latest surgical solution for constipation (ODS): STARR

As many previous attempts to correct defecation disorders through surgery proved unsuccessful, surgeons had few options for rectifying troublesome bowel symptoms. With the emergence of the Stapled Transanal Rectal Resection (STARR) procedure, now the surgeons can easily remove the structural deformities causing ODS through minimally invasive methods.

The introduction of the STARR procedure for correcting defecation disorders In India in 2008 has proved successful. This less-invasive surgical procedure treats ODS to correct all symptoms of chronic constipation and obstructive defecation. As STARR is conducted through the anus, the procedure involves no cuts, incisions, bleeding wounds, or even scars! The hospitalization is much shorter compared to conventional surgery and the recovery after discharge is also very quick. In this link, you can read how Neoalta treats ODS patients.

The STARR procedure for rectifying constipation

Patients undergoing the STARR procedure receive antibiotics before surgery and either spinal or general anesthesia. Then, a round-shaped anal dilator is inserted into the anus and secured with sutures. Afterwards, two surgical staplers are inserted into the anus to remove the excess tissue in the rectum area. This procedure can significantly improve the anatomical defects in human bodies that result in ODS. As this procedure is conducted through the anus, it does not require any incision and generally leaves no visible scars.

Patients undergoing STARR procedure typically

• remain in the hospital for only one to three days
• do not have any visible scars
• experience minimal post-operative pain
• need little recovery time, and resume normal activities in a week or two
• experience significant improvements in defecation after undergoing the procedure

Clinical studies show that the STARR surgical procedure significantly rectified chronic constipation symptoms suffered by patients for years. This study also reported that almost 90% of the patients who underwent this procedure rated the procedure and its results as excellent or good.

Side effects of the STARR Procedure

The known side-effects associated with STARR procedure are anal pain, bleeding, urinary retention, fistula formation, pain during intercourse, and accidental bowel leakage.

Dr Archana Jhawar, M.S. Ent and Hearing Specialist, is the Chief Ent Surgeon at Neoalta. In her role, Dr. Archana will mentor and support the development and implementation of several sub-specialties within the clinic.