Functional Bowel Disease

 

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Functional disorders of the bowel are common and have significant impact on patients’ daily lives. Although most of these conditions are not treated surgically, colorectal surgeons must be knowledgeable of the evaluation and management of these challenging patients, as many come to our clinics. In this issue of Clinics, we cover several facets of the evaluation and management of constipation and functional bowel disorders. First, Dr. Amer Alame, a colorectal fellow, and Dr. Heidi Bahna, a colorectal surgeon, from the University of Miami, discuss the evaluation of constipated patients. Then Dr. Meredith Portalatin, a GI fellow, and Dr. Nathaniel “Teddy” Winstead, a staff gastroenterologist, from Ochsner, provide guidance on the medical management of constipation. Dr. Jacob McCoy, from the University of Texas Medical School in Houston, and I then summarize the reported experience with surgical management of constipation. Drs. C. Neal Ellis and Rahila Essani from the West Penn Allegheny Health System in Pittsburgh describe the challenge of treating outlet obstruction. Drs. Cullen, Roselli, and Gurland, from the Colorectal Surgery Department at the Cleveland Clinic review ventral mesh rectopexy.

Dr. Arpana Jain, a surgical resident, and Dr. David Vargas, Chief of Colorectal Surgery at the University of Kentucky in Lexington, discuss acute intestinal pseudo-obstruction. Dr. Kaitlin Occhipinti, a GI fellow, and Dr. James Smith, Assistant Chairman of Gastroenterology at Ochsner, describe the medical management options for irritable bowel syndrome. Finally, Dr. Izi Obokhare, a colorectal research fellow at Ochsner, presents a discussion of the mundane, but clinically important issue of fecal impaction.

As the Guest Editor, I would like to thank all the contributors for their excellent efforts and I hope our readers find this issue helpful and informative.