Even surgery may not help patients with severe constipation

Current guidelines for treating severe constipation include surgical removal of part of the colon, a procedure called subtotal colectomy. Using national databases of hospital activity in the United States, investigators have discovered that colectomies for constipation nearly tripled over a span of 13 years, from 104 procedures in 1998 to 311 in 2011.

Forty-three per cent of patients had complications while in the hospital after the surgery, and 29% required readmission in the 30 days after discharge.

"Stool frequency often increases after the surgery, and while this may well sound like success when we think about one of the defining characteristics, it is only one of many factors. Our study clearly shows that the simple increase in stool frequency is not enough to decrease the need for ongoing and often costly care," said Dr. Klaus Bielefeldt, senior author of the Alimentary Pharmacology and Therapeutics study.

"Perhaps more importantly, the surgical approach comes with significant and concerning side effects that affect nearly half of those operated, meaning the risk is high and the promised benefit may be limited."