Segmental Colectomy

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As a general rule, a segmental colectomy is not performed for constipation, as it is very difficult to accurately determine what part of the colon is malfunctioning from the transit study. There are some who believe that using a scintigraphic transit study will delineate if a particular segment malfunctions and only resect that segment. However, because of the need to reoperate on individuals after a segmental resection, colorectal or ileosigmoid anastomosis, a full colectomy and IRA should be performed as the initial operation. Furthermore, the scintigraphic transit study can more precisely show a specific segment of colonic dysmotility.

Notable exceptions are individuals with rectal prolapse and constipation. It is important to realize that internal intussusception has been found to lead to constipation in some individuals. For those with severe constipation, a transit study should be performed. If this is prolonged, a colectomy with IRA and rectopexy is combined to surgically treat both problems. Some patients with rectal prolapse also will have an element of constipation, but this is not considered "severe." This group will benefit from a sigmoid (segmental) colectomy with colorectal anastomosis and rectopexy. Additionally, when performing a rec-topexy for rectal prolapse and the sigmoid kinks over severely when the rectum is pulled up, consideration should be given to performing the sigmoid resection with anastomosis and rectopexy. This could eliminate potential post-operative constipation due to kinking.

A few patients will experience unusual constipation symptoms from sigmoidoceles; these are typically extremely difficult to diagnose. If this is suspected, communication with the radiologist helps to specifically look for this finding while performing the defecating proc-togram. A segmental sigmoid colectomy and colorectal anastomosis with closure of the pelvic floor defect (if possible) is the surgical treatment of choice.

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Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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