Treatment of chronic constipation and resection of the inert rectosigmoid

Abstract

The colon absorbs water from the stool and serves a reservoir function. These processes depend on colonic motility, which is an area of physiology that is not well understood, and for which treatments of problems are limited. In normal individuals the rectosigmoid stores the stool, and every 24-48 h develops active peristaltic waves indicating that it is time to empty. A normal individual feels this sensation and decides when to relax the voluntary sphincter mechanism. Patients with anorectal malformations, as discussed in Chaps. 29, 30 and 33, lack a normal anal canal, have deficient sphincters, and have an accompanying motility disorder, usually hypomotility. Their ability to have a voluntary bowel movement depends on these three factors. Solid stool allows for distension of the distal rectum, and proprioception allows the child to detect this. It is for this reason that loose stools make their ability to be fecally continent much less likely. © 2006 Springer-Verlag.