[Severe chronic XXXX . Is it a problem of surgery?].

@entity1 @entity3087 @entity254 @entity717 @entity1142 @entity1744
Severe chronic @entity1142 is defined as less than two bowel movements per week, hard stools, non productive urgency and the need of digital maneuvers in more than 25% of bowel evacuations. The best studied causes of chronic severe @entity1142 are slow bowel transit @entity3087 . However, there are mixed forms that cross link with @entity1744 . The main diagnostic tests are anorrectal manometry, bowel evacuation, X-ray studies and anorrectal sphincteromyomectomy, that can be therapeutic. Five percent of @entity1 are surgical candidates. In cases of slow bowel movement, total colectomy with @entity254 has satisfactory results in 80 to 90% of @entity1 . Some @entity1 with pelvic floor dysfunction have an occult rectal prolapse, rectocele or sigmoidocele and obtain benefits with the correction of these conditions. The remaining @entity1 require a training of bowel evacuation, known as biofeedback. We have performed a total colectomy in 10 @entity1 with @entity717 with good functional results in 80%. After 56 months of follow-up, a mean 2.6 bowel movements per day is reported by the @entity1 . Four @entity1 were also operated due to a solitary rectal ulcer and two @entity1 due to a sigmoidocele, with satisfactory results.
