[Treatment of severe constipation].

Commonly used therapeutic products in constipation, i.e. fiber supplements and laxatives, are not sufficiently effective for intractable constipation. Biofeedback therapy is utilized in functional obstructed defecation syndrome. Botulin injections into the levator muscle have been described to be beneficial. For some patients, retrograde rectal lavage is sufficient. Slow-transit constipation can also be treated by applying sacral nerve stimulation as well as antegrade lavage through a colonic stoma made into the proximal part of the large intestine. Surgical treatment can be offered for selected patients having a mechanical defecation block. Resection of the bowel is the most common surgical treatment.