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1/3. Geriatric constipation: brief update on a common problem.

    constipation occurs frequently in the elderly and is often multifactorial in origin. A search for an underlying cause is necessary, and can often be found by taking an adequate history and performing a thorough physical examination. A minority of patients require further investigation, guided by the clinical setting. Management should be directed at correcting the underlying cause and providing dietary advice and, less commonly, medication to allow restoration of a normal bowel habit.
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2/3. Pseudo-obstruction of the colon.

    "Pseudo-obstruction of the colon" refers to a condition in which physical and radiological findings identical to those associated with mechanical obstruction of the large bowel are found but in which no organic cause for the colonic distention is present. These cases may involve progressive proximal large bowel dilatation to the point of cecal perforation or necrosis. We have collected eight cases of our own which will be presented. The various etiologic factors reported in the literature will be discussed and analyzed and we will offer an anatomicophysiologic explanation of a possible mechanism, based on sympathetic-parasympathetic neurostimulatory imbalance.
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3/3. colonic pseudo-obstruction following termination of pregnancy and uterine operation.

    colonic pseudo-obstruction refers to a condition in which physical and radiologic findings identical to those associated with mechanical obstruction of the large bowel are found but in which no organic cause of the colonic distention is present. Cases of this condition have been reported in the world literature, of which 40 per cent have followed the termination of pregnancy or uterine operation. Three cases of this syndrome are presented. One followed normal vaginal delivery; one followed cesarean section, and the third followed elective abdominal hysterectomy. The literature on the subject is reviewed, and a possible anatomicophysiologic explanation, based upon a sympathetic-parasympathetic neurostimulatory imbalance, is put forward.
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