There are three types of constipation: slow transit constipation – «lazy bowel», obstructive defecation – «dyschesia» and their combination.
Operative management is a rare solution for this condition, and is reserved for patients who have tried all conservative means and failed. Psychological instability as the cause or result of their symptoms should be excluded or treated, especially for obstructive defecation patients.
Total colectomy is the operation of choice for patients with severe slow transit constipation, with good results.
There are plenty of operative procedures to treat the obstructive defecation either abdominal or through the anus, with moderate results, since only one-half of the patients are improved.