The surgery of idiopathic constipation.

This paper has described the methods of patient evaluation and treatment that have been developed at the Cleveland Clinic Foundation for patients with idiopathic constipation. An orderly concise work-up should identify the small group of patients that will benefit from surgical therapy and assist the surgeon in selecting the type of therapy for the greatest success. Patients with outlet obstruction appear to benefit from anorectal myectomy while those with slow colonic transit should undergo a subtotal colectomy and ileorectal anastomosis. Additional investigations will hopefully increase our knowledge of the best way to manage these patients.