Bassotti G, Blandizzi C. Understanding and treating refractory constipation. World J Gastrointest Pharmacol Ther 2014; 5(2): 77-85 [PMID: 24868488 DOI: 10.4292/wjgpt.v5.i2.77]
Corresponding Author of This Article
Gabrio Bassotti, Professor, Gastroenterology and Hepatology Section, Department of Medicine, University of Perugia, Ospedale Santa Maria della Misericordia, Piazzale Menghini 1, 06156 Perugia, Italy. gabassot@tin.it
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
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World J Gastrointest Pharmacol Ther. May 6, 2014; 5(2): 77-85 Published online May 6, 2014. doi: 10.4292/wjgpt.v5.i2.77
Understanding and treating refractory constipation
Gabrio Bassotti, Corrado Blandizzi
Gabrio Bassotti, Gastroenterology and Hepatology Section, Department of Medicine, University of Perugia, 06156 Perugia, Italy
Corrado Blandizzi, Division of Pharmacology and Chemotherapy, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
Author contributions: Bassotti G ideated the project and wrote the draft; Blandizzi C critically reviewed the manuscript and helped in writing the manuscript; both authors reviewed and approved the final version of the manuscript.
Correspondence to: Gabrio Bassotti, Professor, Gastroenterology and Hepatology Section, Department of Medicine, University of Perugia, Ospedale Santa Maria della Misericordia, Piazzale Menghini 1, 06156 Perugia, Italy. gabassot@tin.it
Telephone: +39-75-5784423 Fax: +39-75-5847570
Received: October 17, 2013 Revised: January 20, 2014 Accepted: February 18, 2014 Published online: May 6, 2014
Core Tip
Core tip: The majority of patients affected by chronic constipation can be managed by conventional therapeutic approaches. However, a subset of constipated patients displays a condition of actual refractoriness to standard medical treatment, even after careful clinical re-evaluation. These patients require more in-depth diagnostic evaluations to ascertain the underlying pathophysiological mechanisms, as well as more intensive, targeted and tailored therapeutic approaches, which may rely on the use of newly released drugs (enterokinetics, enteric secretagogues), rehabilitation (biofeedback), invasive measures (sacral neuromodulation, local injection of botulinum toxin, antegrade continence enemas) and surgical procedures (subtotal colectomy with ileorectal anastomosis or stapled transanal rectal resection).
