Our Summary

This research paper looks at the use of colectomy (removal of all or part of the colon) as a treatment for severe constipation that doesn’t respond to other treatments. The researchers used data from US medical databases to look at how many people had this surgery for constipation between 1998 and 2011, how often they had complications or had to return to the hospital, and whether they used fewer healthcare resources after the surgery.

They found that the number of these surgeries for constipation increased from 104 in 1998 to 311 in 2011. Almost half (42.7%) of patients had complications during their stay in the hospital for the surgery. For patients who were followed for a longer time, almost a third had to be readmitted to the hospital within the first 30 days after surgery. The number of emergency department visits didn’t change after surgery, but the number of hospitalizations increased.

These findings suggest that colectomy for severe constipation is becoming more common, often leads to complications, and doesn’t reduce the use of healthcare resources. This raises questions about whether this surgery is really the best treatment for this type of constipation.

FAQs

  1. Has there been an increase in the number of colectomies performed for severe constipation?
  2. What percentage of patients experienced complications during their hospital stay for a colectomy?
  3. Does a colectomy for severe constipation reduce the use of healthcare resources?

Doctor’s Tip

One helpful tip a doctor might tell a patient about colectomy is to carefully consider all other treatment options before resorting to surgery. It’s important to discuss the potential risks and complications of colectomy, as well as the potential impact on quality of life post-surgery. Patients should also be aware of the possibility of needing further medical care or hospitalizations after the surgery. Consulting with a healthcare provider and getting a second opinion if needed can help ensure that the decision to undergo colectomy is the best course of action for the individual patient.

Suitable For

Patients who are typically recommended colectomy for severe constipation are those who have not responded to other treatments such as dietary changes, medications, and behavioral therapies. These patients may have chronic constipation that significantly impacts their quality of life and daily functioning. They may also have underlying medical conditions that contribute to their constipation, such as pelvic floor dysfunction or irritable bowel syndrome.

In some cases, patients may have a structural issue in their colon that is causing the severe constipation, such as colonic inertia or slow transit constipation. These patients may benefit from colectomy as a last resort treatment option to improve their symptoms and quality of life.

It is important for patients considering colectomy for severe constipation to discuss the risks and benefits of the surgery with their healthcare provider. They should also explore other treatment options and consider seeking a second opinion before making a decision about surgery.

Timeline

Before colectomy:

  1. Patients experience severe constipation that does not respond to other treatments.
  2. They may undergo various diagnostic tests and consultations with healthcare providers to determine the best course of action.
  3. Patients may try different medications, dietary changes, and other non-invasive treatments to manage their symptoms.
  4. If these treatments are unsuccessful, patients may be recommended for colectomy as a last resort.

After colectomy:

  1. Patients undergo the surgical procedure to remove part or all of the colon.
  2. They may experience complications during their hospital stay, with almost half of patients experiencing issues.
  3. Within the first 30 days after surgery, almost a third of patients may need to be readmitted to the hospital.
  4. The number of emergency department visits does not change after surgery, but the number of hospitalizations increases.
  5. It is unclear if colectomy for severe constipation effectively reduces symptoms and improves quality of life, as the use of healthcare resources does not decrease following the surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with colectomy surgery for severe constipation?
  2. How likely is it that I will experience complications or need to be readmitted to the hospital after the surgery?
  3. What other treatment options are available for severe constipation that hasn’t responded to other treatments?
  4. How will my quality of life be affected after colectomy surgery?
  5. Will I need to make any significant lifestyle changes or follow a special diet after the surgery?
  6. How long is the recovery period after colectomy surgery, and what can I expect during this time?
  7. Will I need to take any medications or undergo additional therapies after the surgery?
  8. How often will I need follow-up appointments or monitoring after the surgery?
  9. Are there any long-term effects or complications that I should be aware of after having a colectomy?
  10. Can you provide me with information on the success rates of colectomy surgery for severe constipation, based on your experience and expertise?

Reference

Authors: Dudekula A, Huftless S, Bielefeldt K. Journal: Aliment Pharmacol Ther. 2015 Dec;42(11-12):1281-93. doi: 10.1111/apt.13415. Epub 2015 Oct 1. PMID: 26423574