Functional Disorders: Slow-Transit Constipation

 

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Abstract

Constipation is a very common complaint, with slow-transit constipation (STC) accounting for a significant proportion of cases. Old age, female gender, psychiatric illness, and history of sexual abuse are all associated with STC. The exact cause of STC remains elusive; however, multiple immune and cellular changes have been demonstrated. Diagnosis requires evidence of slowed colonic transit which may be achieved via numerous modalities. While a variety of medical therapies exist, these are often met with limited success and a minority of patients ultimately require operative intervention. When evaluating a patient with STC, it is important to determine the presence of concomitant obstructed defecation or other forms of enteric dysmotility, as this may affect treatment decisions. Although a variety of surgical procedures have been reported, subtotal colectomy with ileorectal anastomosis is the most commonly performed and well-studied procedure, with the best track record of success.

• References

• 1 Higgins PD, Johanson JF. Epidemiology of constipation in North America: a systematic review. Am J Gastroenterol 2004; 99 (4) 750-759
  CrossrefPubMedGoogle Scholar
• 2 DiPalma JA. Current treatment options for chronic constipation. Rev Gastroenterol Disord 2004; 4 (Suppl. 02) S34-S42
  PubMedGoogle Scholar
• 3 Dhruva Rao PK, Lewis M, Peiris SP, Shah PR, Haray PN. Long-term outcome of prucalopride for chronic constipation: a single-centre study. Colorectal Dis 2015; 17 (12) 1079-1084
  CrossrefPubMedGoogle Scholar
• 4 Alame AM, Bahna H. Evaluation of constipation. Clin Colon Rectal Surg 2012; 25 (1) 5-11
  Article in Thieme ConnectPubMedGoogle Scholar
• 5 Johanson JF, Sonnenberg A, Koch TR. Clinical epidemiology of chronic constipation. J Clin Gastroenterol 1989; 11 (5) 525-536
  CrossrefPubMedGoogle Scholar
• 6 Rao SS, Coss-Adame E, Valestin J, Mysore K. Evaluation of constipation in older adults: radioopaque markers (ROMs) versus wireless motility capsule (WMC). Arch Gerontol Geriatr 2012; 55 (2) 289-294
  CrossrefPubMedGoogle Scholar
• 7 Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC. Functional bowel disorders. Gastroenterology 2006; 130 (5) 1480-1491
  Google Scholar
• 8 Denoya P, Sands DR. Anorectal physiologic evaluation of constipation. Clin Colon Rectal Surg 2008; 21 (2) 114-121
  Article in Thieme ConnectPubMedGoogle Scholar
• 9 Shahid S, Ramzan Z, Maurer AH, Parkman HP, Fisher RS. Chronic idiopathic constipation: more than a simple colonic transit disorder. J Clin Gastroenterol 2012; 46 (2) 150-154
  CrossrefPubMedGoogle Scholar
• 10 El-Salhy M. Chronic idiopathic slow transit constipation: pathophysiology and management. Colorectal Dis 2003; 5 (4) 288-296
  CrossrefPubMedGoogle Scholar
• 11 Bassotti G, Roberto GD, Sediari L, Morelli A. Toward a definition of colonic inertia. World J Gastroenterol 2004; 10 (17) 2465-2467
  CrossrefPubMedGoogle Scholar
• 12 Frattini JC, Nogueras JJ. Slow transit constipation: a review of a colonic functional disorder. Clin Colon Rectal Surg 2008; 21 (2) 146-152
  Article in Thieme ConnectPubMedGoogle Scholar
• 13 Surrenti E, Rath DM, Pemberton JH, Camilleri M. Audit of constipation in a tertiary referral gastroenterology practice. Am J Gastroenterol 1995; 90 (9) 1471-1475
  PubMedGoogle Scholar
• 14 O'Brien S, Hyman N, Osler T, Rabinowitz T. Sexual abuse: a strong predictor of outcomes after colectomy for slow-transit constipation. Dis Colon Rectum 2009; 52 (11) 1844-1847
  CrossrefPubMedGoogle Scholar
• 15 Reshef A, Alves-Ferreira P, Zutshi M, Hull T, Gurland B. Colectomy for slow transit constipation: effective for patients with coexistent obstructed defecation. Int J Colorectal Dis 2013; 28 (6) 841-847
  CrossrefPubMedGoogle Scholar
• 16 Corman M. Colon and Rectal Surgery. 5th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2005: 457-486
  Google Scholar
• 17 Bassotti G, Chiarioni G, Imbimbo BP , et al. Impaired colonic motor response to cholinergic stimulation in patients with severe chronic idiopathic (slow transit type) constipation. Dig Dis Sci 1993; 38 (6) 1040-1045
  CrossrefPubMedGoogle Scholar
• 18 Bassotti G, Chistolini F, Nzepa FS, Morelli A. Colonic propulsive impairment in intractable slow-transit constipation. Arch Surg 2003; 138 (12) 1302-1304
  CrossrefPubMedGoogle Scholar
• 19 Shafik A, Shafik AA, El-Sibai O, Ahmed I. Colonic pacing. A therapeutic option for the treatment of constipation due to total colonic inertia. Arch Surg 2003; 138 (7) 1007-1011
  CrossrefPubMedGoogle Scholar
• 20 He C-L, Burgart L, Wang L , et al. Decreased interstitial cell of cajal volume in patients with slow-transit constipation. Gastroenterology 2000; 118 (1) 14-21
  CrossrefPubMedGoogle Scholar
• 21 Bassotti G, Stanghellini V, Chiarioni G , et al. Upper gastrointestinal motor activity in patients with slow-transit constipation. Further evidence for an enteric neuropathy. Dig Dis Sci 1996; 41 (10) 1999-2005
  CrossrefPubMedGoogle Scholar
• 22 Camilleri M, Fealey RD. Idiopathic autonomic denervation in eight patients presenting with functional gastrointestinal disease. A causal association?. Dig Dis Sci 1990; 35 (5) 609-616
  CrossrefPubMedGoogle Scholar
• 23 Knowles CH, Scott SM, Lunniss PJ. Slow transit constipation: a disorder of pelvic autonomic nerves?. Dig Dis Sci 2001; 46 (2) 389-401
  CrossrefPubMedGoogle Scholar
• 24 Dinning PG, Fuentealba SE, Kennedy ML, Lubowski DZ, Cook IJ. Sacral nerve stimulation induces pan-colonic propagating pressure waves and increases defecation frequency in patients with slow-transit constipation. Colorectal Dis 2007; 9 (2) 123-132
  CrossrefPubMedGoogle Scholar
• 25 Bassotti G, Villanacci V, Rostami Nejad M. Chronic constipation: no more idiopathic, but a true neuropathological entity. Gastroenterol Hepatol Bed Bench 2011; 4 (3) 109-115
  PubMedGoogle Scholar
• 26 Wang HL. Understanding the pathogenesis of slow-transit constipation: one step forward. Dig Dis Sci 2015; 60 (8) 2216-2218
  CrossrefPubMedGoogle Scholar
• 27 Han EC, Oh HK, Ha HK , et al. Favorable surgical treatment outcomes for chronic constipation with features of colonic pseudo-obstruction. World J Gastroenterol 2012; 18 (32) 4441-4446
  CrossrefPubMedGoogle Scholar
• 28 Bassotti G, Villanacci V, Nascimbeni R , et al. Colonic mast cells in controls and slow transit constipation patients. Aliment Pharmacol Ther 2011; 34 (1) 92-99
  CrossrefPubMedGoogle Scholar
• 29 Liu W, Zhang Q, Li S , et al. The relationship between colonic macrophages and microRNA-128 in the pathogenesis of slow transit constipation. Dig Dis Sci 2015; 60 (8) 2304-2315
  CrossrefPubMedGoogle Scholar
• 30 Lyford GL, He C-L, Soffer E , et al. Pan-colonic decrease in interstitial cells of Cajal in patients with slow transit constipation. Gut 2002; 51 (4) 496-501
  CrossrefPubMedGoogle Scholar
• 31 Toman J, Turina M, Ray M, Petras RE, Stromberg AJ, Galandiuk S. Slow transit colon constipation is not related to the number of interstitial cells of Cajal. Int J Colorectal Dis 2006; 21 (6) 527-532
  CrossrefPubMedGoogle Scholar
• 32 Scott SM, Knowles CH, Newell M, Garvie N, Williams NS, Lunniss PJ. Scintigraphic assessment of colonic transit in women with slow-transit constipation arising de novo and following pelvic surgery or childbirth. Br J Surg 2001; 88 (3) 405-411
  CrossrefPubMedGoogle Scholar
• 33 Roe AM, Bartolo DC, Mortensen NJ. Slow transit constipation. Comparison between patients with or without previous hysterectomy. Dig Dis Sci 1988; 33 (9) 1159-1163
  CrossrefPubMedGoogle Scholar
• 34 Zhao RH, Baig MK, Thaler KJ , et al. Reduced expression of serotonin receptor(s) in the left colon of patients with colonic inertia. Dis Colon Rectum 2003; 46 (1) 81-86
  CrossrefPubMedGoogle Scholar
• 35 Guarino M, Cheng L, Cicala M, Ripetti V, Biancani P, Behar J. Progesterone receptors and serotonin levels in colon epithelial cells from females with slow transit constipation. Neurogastroenterol Motil 2011; 23 (6) 575-e210
  CrossrefPubMedGoogle Scholar
• 36 Bharucha AE, Dorn SD, Lembo A, Pressman A ; American Gastroenterological Association. American Gastroenterological Association medical position statement on constipation. Gastroenterology 2013; 144 (1) 211-217
  CrossrefPubMedGoogle Scholar
• 37 Pepin C, Ladabaum U. The yield of lower endoscopy in patients with constipation: survey of a university hospital, a public county hospital, and a Veterans Administration medical center. Gastrointest Endosc 2002; 56 (3) 325-332
  CrossrefPubMedGoogle Scholar
• 38 Beck DE, Jagelman DG, Fazio VW. The surgery of idiopathic constipation. Gastroenterol Clin North Am 1987; 16 (1) 143-156
  PubMedGoogle Scholar
• 39 Prokesch RW, Breitenseher MJ, Kettenbach J , et al. Assessment of chronic constipation: colon transit time versus defecography. Eur J Radiol 1999; 32 (3) 197-203
  CrossrefPubMedGoogle Scholar
• 40 Rao SS, Singh S. Clinical utility of colonic and anorectal manometry in chronic constipation. J Clin Gastroenterol 2010; 44 (9) 597-609
  CrossrefPubMedGoogle Scholar
• 41 Bove A, Pucciani F, Bellini M , et al. Consensus statement AIGO/SICCR: diagnosis and treatment of chronic constipation and obstructed defecation (part I: diagnosis). World J Gastroenterol 2012; 18 (14) 1555-1564
  CrossrefPubMedGoogle Scholar
• 42 Metcalf A, Ross H. Constipation. In: Wolff B, Fleshmann J, Beck D, Pemberton J, Wexner S, , eds. ASCRS Textbook of Colon and Rectal Surgery. New York, NY: Springer; 2007: 678-686
  CrossrefGoogle Scholar
• 43 McCoy JA, Beck DE. Surgical management of colonic inertia. Clin Colon Rectal Surg 2012; 25 (1) 20-23
  Article in Thieme ConnectPubMedGoogle Scholar
• 44 Xu HM, Han JG, Na Y, Zhao B, Ma HC, Wang ZJ. Colonic transit time in patient with slow-transit constipation: comparison of radiopaque markers and barium suspension method. Eur J Radiol 2011; 79 (2) 211-213
  CrossrefPubMedGoogle Scholar
• 45 Yuan W, Zhang Z, Liu J , et al. Simplified assessment of segmental gastrointestinal transit time with orally small amount of barium. Eur J Radiol 2012; 81 (9) 1986-1989
  CrossrefPubMedGoogle Scholar
• 46 Lu L, Yan G, Sun J. A study of human colonic motility in healthy and constipated subjects using the wireless capsule. Comput Biol Med 2015; 65: 269-278
  CrossrefPubMedGoogle Scholar
• 47 Portalatin M, Winstead N. Medical management of constipation. Clin Colon Rectal Surg 2012; 25 (1) 12-19
  Article in Thieme ConnectPubMedGoogle Scholar
• 48 Voderholzer WA, Schatke W, Mühldorfer BE, Klauser AG, Birkner B, Müller-Lissner SA. Clinical response to dietary fiber treatment of chronic constipation. Am J Gastroenterol 1997; 92 (1) 95-98
  PubMedGoogle Scholar
• 49 Meshkinpour H, Selod S, Movahedi H, Nami N, James N, Wilson A. Effects of regular exercise in management of chronic idiopathic constipation. Dig Dis Sci 1998; 43 (11) 2379-2383
  CrossrefPubMedGoogle Scholar
• 50 Bassotti G, Blandizzi C. Understanding and treating refractory constipation. World J Gastrointest Pharmacol Ther 2014; 5 (2) 77-85
  CrossrefPubMedGoogle Scholar
• 51 Spiller R. Serotonergic modulating drugs for functional gastrointestinal diseases. Br J Clin Pharmacol 2002; 54 (1) 11-20
  CrossrefPubMedGoogle Scholar
• 52 Kang SB, Marchelletta RR, Penrose H, Docherty MJ, McCole DF. A comparison of linaclotide and lubiprostone dosing regimens on ion transport responses in human colonic mucosa. Pharmacol Res Perspect 2015; 3 (2) e00128
  CrossrefPubMedGoogle Scholar
• 53 Thomas RH, Luthin DR. Current and emerging treatments for irritable bowel syndrome with constipation and chronic idiopathic constipation: focus on prosecretory agents. Pharmacotherapy 2015; 35 (6) 613-630
  CrossrefPubMedGoogle Scholar
• 54 Love BL, Johnson A, Smith LS. Linaclotide: a novel agent for chronic constipation and irritable bowel syndrome. Am J Health Syst Pharm 2014; 71 (13) 1081-1091
  CrossrefPubMedGoogle Scholar
• 55 Corsetti M, Tack J. New pharmacological treatment options for chronic constipation. Expert Opin Pharmacother 2014; 15 (7) 927-941
  CrossrefPubMedGoogle Scholar
• 56 Wilson N, Schey R. Lubiprostone in constipation: clinical evidence and place in therapy. Ther Adv Chronic Dis 2015; 6 (2) 40-50
  CrossrefPubMedGoogle Scholar
• 57 Jiang J, Yi Y, Zhan L. Acupuncture: a good choice to patients with intractable slow-transit constipation. Int J Colorectal Dis 2015; 30 (5) 721-722
  CrossrefPubMedGoogle Scholar
• 58 Chan DS, Saklani A, Shah PR, Lewis M, Haray PN. Rectal irrigation: a useful tool in the armamentarium for functional bowel disorders. Colorectal Dis 2012; 14 (6) 748-752
  CrossrefPubMedGoogle Scholar
• 59 Brown SR, Donati D, Seow-Choen F, Ho Y-H. Biofeedback avoids surgery in patients with slow-transit constipation: report of four cases. Dis Colon Rectum 2001; 44 (5) 737-739 , discussion 739–740
  CrossrefPubMedGoogle Scholar
• 60 Chiotakakou-Faliakou E, Kamm MA, Roy AJ, Storrie JB, Turner IC. Biofeedback provides long-term benefit for patients with intractable, slow and normal transit constipation. Gut 1998; 42 (4) 517-521
  CrossrefPubMedGoogle Scholar
• 61 Battaglia E, Serra AM, Buonafede G , et al. Long-term study on the effects of visual biofeedback and muscle training as a therapeutic modality in pelvic floor dyssynergia and slow-transit constipation. Dis Colon Rectum 2004; 47 (1) 90-95
  CrossrefPubMedGoogle Scholar
• 62 Wang J, Luo M-H, Qi Q-H, Dong Z-L. Prospective study of biofeedback retraining in patients with chronic idiopathic functional constipation. World J Gastroenterol 2003; 9 (9) 2109-2113
  CrossrefPubMedGoogle Scholar
• 63 Pikarsky AJ, Singh JJ, Weiss EG, Nogueras JJ, Wexner SD. Long-term follow-up of patients undergoing colectomy for colonic inertia. Dis Colon Rectum 2001; 44 (2) 179-183
  CrossrefPubMedGoogle Scholar
• 64 Pinedo G, Zarate AJ, Garcia E, Molina ME, Lopez F, Zúñiga A. Laparoscopic total colectomy for colonic inertia: surgical and functional results. Surg Endosc 2009; 23 (1) 62-65
  CrossrefPubMedGoogle Scholar
• 65 Riss S, Herbst F, Birsan T, Stift A. Postoperative course and long term follow up after colectomy for slow transit constipation—is surgery an appropriate approach?. Colorectal Dis 2009; 11 (3) 302-307
  CrossrefPubMedGoogle Scholar
• 66 Nyam DC, Pemberton JH, Ilstrup DM, Rath DM. Long-term results of surgery for chronic constipation. Dis Colon Rectum 1997; 40 (3) 273-279
  CrossrefPubMedGoogle Scholar
• 67 FitzHarris GP, Garcia-Aguilar J, Parker SC , et al. Quality of life after subtotal colectomy for slow-transit constipation: both quality and quantity count. Dis Colon Rectum 2003; 46 (4) 433-440
  CrossrefPubMedGoogle Scholar
• 68 Sohn G, Yu CS, Kim CW , et al. Surgical outcomes after total colectomy with ileorectal anastomosis in patients with medically intractable slow transit constipation. J Korean Soc Coloproctol 2011; 27 (4) 180-187
  CrossrefPubMedGoogle Scholar
• 69 Verne GN, Hocking MP, Davis RH , et al. Long-term response to subtotal colectomy in colonic inertia. J Gastrointest Surg 2002; 6 (5) 738-744
  CrossrefPubMedGoogle Scholar
• 70 Athanasakis H, Tsiaoussis J, Vassilakis JS, Xynos E. Laparoscopically assisted subtotal colectomy for slow-transit constipation. Surg Endosc 2001; 15 (10) 1090-1092
  CrossrefPubMedGoogle Scholar
• 71 Ho YH, Tan M, Eu KW, Leong A, Choen FS. Laparoscopic-assisted compared with open total colectomy in treating slow transit constipation. Aust N Z J Surg 1997; 67 (8) 562-565
  CrossrefPubMedGoogle Scholar
• 72 You YT, Wang JY, Changchien CR , et al. Segmental colectomy in the management of colonic inertia. Am Surg 1998; 64 (8) 775-777
  PubMedGoogle Scholar
• 73 Ghosh S, Papachrysostomou M, Batool M, Eastwood MA. Long-term results of subtotal colectomy and evidence of noncolonic involvement in patients with idiopathic slow-transit constipation. Scand J Gastroenterol 1996; 31 (11) 1083-1091
  CrossrefPubMedGoogle Scholar
• 74 Platell C, Scache D, Mumme G, Stitz R. A long-term follow-up of patients undergoing colectomy for chronic idiopathic constipation. Aust N Z J Surg 1996; 66 (8) 525-529
  CrossrefPubMedGoogle Scholar
• 75 Lubowski DZ, Chen FC, Kennedy ML, King DW. Results of colectomy for severe slow transit constipation. Dis Colon Rectum 1996; 39 (1) 23-29
  CrossrefPubMedGoogle Scholar
• 76 Jiang CQ, Qian Q, Liu ZS, Bangoura G, Zheng KY, Wu YH. Subtotal colectomy with antiperistaltic cecoproctostomy for selected patients with slow transit constipation-from Chinese report. Int J Colorectal Dis 2008; 23 (12) 1251-1256
  CrossrefPubMedGoogle Scholar
• 77 Hsiao KC, Jao SW, Wu CC, Lee TY, Lai HJ, Kang JC. Hand-assisted laparoscopic total colectomy for slow transit constipation. Int J Colorectal Dis 2008; 23 (4) 419-424
  CrossrefPubMedGoogle Scholar
• 78 Sheng QS, Lin JJ, Chen WB , et al. Comparison of hand-assisted laparoscopy with open total colectomy for slow transit constipation: a retrospective study. J Dig Dis 2014; 15 (8) 419-424
  CrossrefPubMedGoogle Scholar
• 79 Zutshi M, Hull TL, Trzcinski R, Arvelakis A, Xu M. Surgery for slow transit constipation: are we helping patients?. Int J Colorectal Dis 2007; 22 (3) 265-269
  CrossrefPubMedGoogle Scholar
• 80 Thaler K, Dinnewitzer A, Oberwalder M , et al. Quality of life after colectomy for colonic inertia. Tech Coloproctol 2005; 9 (2) 133-137
  CrossrefPubMedGoogle Scholar
• 81 Knowles CH, Scott M, Lunniss PJ. Outcome of colectomy for slow transit constipation. Ann Surg 1999; 230 (5) 627-638
  CrossrefPubMedGoogle Scholar
• 82 Iannelli A, Fabiani P, Mouiel J, Gugenheim J. Laparoscopic subtotal colectomy with cecorectal anastomosis for slow-transit constipation. Surg Endosc 2006; 20 (1) 171-173
  CrossrefPubMedGoogle Scholar
• 83 Marchesi F, Sarli L, Percalli L , et al. Subtotal colectomy with antiperistaltic cecorectal anastomosis in the treatment of slow-transit constipation: long-term impact on quality of life. World J Surg 2007; 31 (8) 1658-1664
  CrossrefPubMedGoogle Scholar
• 84 Lundin E, Karlbom U, Påhlman L, Graf W. Outcome of segmental colonic resection for slow-transit constipation. Br J Surg 2002; 89 (10) 1270-1274
  CrossrefPubMedGoogle Scholar
• 85 Akervall S, Fasth S, Nordgren S, Oresland T, Hultén L. The functional results after colectomy and ileorectal anastomosis for severe constipation (Arbuthnot Lane's disease) as related to rectal sensory function. Int J Colorectal Dis 1988; 3 (2) 96-101
  CrossrefPubMedGoogle Scholar
• 86 Kalbassi MR, Winter DC, Deasy JM. Quality-of-life assessment of patients after ileal pouch-anal anastomosis for slow-transit constipation with rectal inertia. Dis Colon Rectum 2003; 46 (11) 1508-1512
  CrossrefPubMedGoogle Scholar
• 87 Sarli L, Costi R, Sarli D, Roncoroni L. Pilot study of subtotal colectomy with antiperistaltic cecoproctostomy for the treatment of chronic slow-transit constipation. Dis Colon Rectum 2001; 44 (10) 1514-1520
  CrossrefPubMedGoogle Scholar
• 88 Feng Y, Jianjiang L. Functional outcomes of two types of subtotal colectomy for slow-transit constipation: ileosigmoidal anastomosis and cecorectal anastomosis. Am J Surg 2008; 195 (1) 73-77
  CrossrefPubMedGoogle Scholar
• 89 Ding W, Jiang J, Feng X, Ni L, Li J, Li N. Clinical and pelvic morphologic correlation after subtotal colectomy with colorectal anastomosis for combined slow-transit constipation and obstructive defecation. Dis Colon Rectum 2015; 58 (1) 91-96
  CrossrefPubMedGoogle Scholar
• 90 Ghellal A, Trilling B, Izard G, Faucheron JL. Permanent ileostomy as the last surgical option for severe slow-transit constipation. Tech Coloproctol 2015; 19 (6) 373-374
  CrossrefPubMedGoogle Scholar
• 91 Li N, Jiang J, Feng X, Ding W, Liu J, Li J. Long-term follow-up of the Jinling procedure for combined slow-transit constipation and obstructive defecation. Dis Colon Rectum 2013; 56 (1) 103-112
  CrossrefPubMedGoogle Scholar
• 92 Kenefick NJ, Vaizey CJ, Cohen CR, Nicholls RJ, Kamm MA. Double-blind placebo-controlled crossover study of sacral nerve stimulation for idiopathic constipation. Br J Surg 2002; 89 (12) 1570-1571
  CrossrefPubMedGoogle Scholar
• 93 Malouf AJ, Wiesel PH, Nicholls T, Nicholls RJ, Kamm MA. Short-term effects of sacral nerve stimulation for idiopathic slow transit constipation. World J Surg 2002; 26 (2) 166-170
  CrossrefPubMedGoogle Scholar
• 94 Rongen MJ, van der Hoop AG, Baeten CG. Cecal access for antegrade colon enemas in medically refractory slow-transit constipation: a prospective study. Dis Colon Rectum 2001; 44 (11) 1644-1649
  CrossrefPubMedGoogle Scholar
• 95 Worsøe J, Christensen P, Krogh K, Buntzen S, Laurberg S. Long-term results of antegrade colonic enema in adult patients: assessment of functional results. Dis Colon Rectum 2008; 51 (10) 1523-1528
  CrossrefPubMedGoogle Scholar
• 96 Lu ML, He J, Lu S. Electrical stimulation therapy for slow transit constipation in children: a systematic review. Int J Colorectal Dis 2015; 30 (5) 697-702
  CrossrefPubMedGoogle Scholar
• 97 Glia A, Akerlund JE, Lindberg G. Outcome of colectomy for slow-transit constipation in relation to presence of small-bowel dysmotility. Dis Colon Rectum 2004; 47 (1) 96-102
  CrossrefPubMedGoogle Scholar
• 98 Marchesi F, Percalli L, Pinna F, Cecchini S, Ricco' M, Roncoroni L. Laparoscopic subtotal colectomy with antiperistaltic cecorectal anastomosis: a new step in the treatment of slow-transit constipation. Surg Endosc 2012; 26 (6) 1528-1533
  CrossrefPubMedGoogle Scholar
• 99 Pemberton JH, Rath DM, Ilstrup DM. Evaluation and surgical treatment of severe chronic constipation. Ann Surg 1991; 214 (4) 403-411 , discussion 411–413
  CrossrefPubMedGoogle Scholar
• 100 Dinning PG, Hunt L, Patton V , et al. Treatment efficacy of sacral nerve stimulation in slow transit constipation: a two-phase, double-blind randomized controlled crossover study. Am J Gastroenterol 2015; 110 (5) 733-740
  CrossrefPubMedGoogle Scholar
• 101 Ratto C, Ganio E, Naldini G ; GINS. Long-term results following sacral nerve stimulation for chronic constipation. Colorectal Dis 2015; 17 (4) 320-328
  CrossrefPubMedGoogle Scholar
• 102 Meurette G, Lehur PA, Coron E, Regenet N. Long-term results of Malone's procedure with antegrade irrigation for severe chronic constipation. Gastroenterol Clin Biol 2010; 34 (3) 209-212
  CrossrefPubMedGoogle Scholar