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Laparoscopic, G.I. & colorectal surgery, Navi Mumbai, India

  Click to call +919833290590


Constipation treatment

When to visit a doctor for constipation?

If constipation is persistent (more than 3 weeks) or if there are any warning signs (blood in stool, loss of weight or loss of appetite) a person should visit a colorectal specialist
Serious causes of constipation like cancer should be ruled out.

Most people in India suffer from constipation in one form or another, although it is not commonly talked about. Obstructed defecation syndrome or ODS is a chronic defecation disorder that affects thousands especially the women.

Typically constipation symptoms include irregular bowel habits, frequent use of laxatives, strained defecation, or incomplete defecation.

Constipation is treated by lifestyle modifications and treatment of the cause of the constipations but surgery may be advised for selected cases of constipation or ODS.

What can lead to constipation?

  • Avoiding the desire to bowel movement
  • Negligible physical activity
  • Irregular eating habit
  • Health issues like thyroid, colon cancer, stroke, Parkinson’s disease, irritable bowel syndrome and diabetes.
  • Certain medications may also lead to constipation.

How to diagnose chronic constipation/ODS?

Checklist of symptoms

  • Weekly bowel movements fewer than three
  • Strained defecation in at least 25 percent of the instances
  • A feeling of incomplete defecation at least 25 percent of the instances
  • Hard stools at least 25 percent of the instances.

If a person has experienced two or more of the above conditions for more than three months, it is highly likely that the person is suffering from chronic constipation or ODS, and needs a surgical treatment.

MR Defecography may be advised to study the changes in the rectal and anal canals during bowel movements which are not ordinarily seen in a colonoscopy or sigmoidoscopy.

Anal Manometry is useful.

Types of constipation & Treatments

3 broad types of constipation are:

  • Normal transit constipation,
  • Slow transit constipation
  • Pelvic floor dysfunction

Normal Transit Constipation can be treated with fibre therapy, laxatives, and other drugs recommended by the doctor; Slow Transit Constipation treatment involves, varying medicines and surgical options.

To treat Pelvic Floor Dysfunction (Outlet Obstruction), Biofeedback therapy is the first step for patients. The main goal of the therapy is to break the pattern of inappropriate (paradoxical) sphincter contraction by training patients to relax their pelvic floor muscles.

Often injection is used to alleviate non-relaxation or paradoxical contraction of involved muscles.

The surgery for different types of constipation

Surgeries for outlet obstruction constipation are limited. A complete preoperative evaluation and careful selection is required for optimal rectocele repair.

Very few patients may require a colon resection by open surgery or laparoscopic surgery.

Antegrade Continent Enema (ACE), small opening in the appendix, upper colon or small intestine are created and cleared on a regular basis to empty the large bowel. Mostly children with incontinence or severe constipation undergo this procedure.

Surgery for Obstructive Defecation Syndrome popularly known as STARR: Stapled Transanal Rectal Resection has proved to be successful than any other surgery for constipation.

The latest solution for constipation (ODS): STARR surgery in Mumbai

With the emergence of the Stapled Transanal Rectal Resection (STARR) procedure, now the specialist colorectal surgeons can easily remove the structural deformities causing ODS through minimally invasive methods.
As STARR is conducted through the anus, the procedure involves no cuts, incisions, bleeding wounds, or even scars! The hospitalization is much shorter compared to conventional surgery and the recovery after discharge is also very quick.

Clinical studies show that the STARR surgical procedure significantly rectified chronic constipation symptoms suffered by patients for years. This study also reported that almost 90% of the patients who underwent this procedure rated the procedure and its results as excellent or good.

Side effects of the STARR Procedure

The known side-effects associated with STARR procedure are anal pain, bleeding, urinary retention, fistula formation, pain during intercourse, and accidental bowel leakage.

Dr Nitish Jhawar – Gen, laparoscopic and colorectal surgeon with 17 years extensive experience in the field is head of the one stop colorectal clinic. He has fellowship of Association of Colorectal Surgeons of India (FACRSI) along with Fellowship in colorectal surgeries from US.

He has received advance training in proctology and constipation treatment. He is performed number of successful STARR surgery for constipation in Mumbai, India.


What patient says about Dr. Nitish Jhawar

  • Person Image

    I was diagnosed with gall stones a year ago in Delhi, I showed it to a doctor at M.... hospital, he .... asked me to get a surgery done and get my gall removed on any date of my choice, I was sacred and too young to get it done I got a vibe from doctor that for him it’s just a small things, however according to for a patient it’s important first be convinced on the urgency to get it done and feel safe . A year later I shifted to Mumbai and started having a frequent pain in shoulder blades and gall area. It went sharp this time. We went to Dr Nitish , as oppose to Delhi doc, Dr Nitish was very polite, first asked us to get the scan done and understand the current scenario, the scan showed one big 17 mm stone which was earlier also there but this time also there were multiple various sized stones as well along with the big one. Dr Nitish examined the scan, explained me and my husband about the condition and need of surgery or else the stone Would have slipped in the panacea or bile calling for a bigger operation. He explained diagramatically . He was patient in explaining, gave us time to think and be convinced. We were ready and then he performed it . It was flawless, quick and went well. He is a very experienced and fine surgeon , he is caring and doesn’t create panic at all rather he takes it slowly and makes patient comfortable. It was lapro, it’s been 2 months I m writing this . I faced no issues till now. Fortis staff was also very caring and good. I would mention fortis Vashi in specific. Good follow up diet makes it normal. I would strongly recommend Dr Nitish. He knows his job perfectly. He is not money minded at all. He would recommend surgery only if it’s required.

  • I had surgery of my left hydrocele on 27th May 2017 by Dr Nitish Jhawar. An excellent experience of service I got particularly from Dr Jhawar. He is not only a qualified experienced doctor but also a splendid human being. Thanks a lot.

  • It was a Laparoscopic operation for the removal of Gall Bladder (stones). I had developed on and off pain in abdomen before the operation, after the operation feeling good, totally pain free. Thanks and respect for handling my case very well.

  • Person Image

    I met doctor Nitish for piles problem and wanted to undergo LASER procedure only, my operation is successful and I thank doctor for being a good human being and great surgeon.

  • Person Image

    I was suffering from piles since long time. For bleeding heavily I met Dr Nitish Jhawar and after meeting him decided to go for Stapler surgery for piles. I found him a doctor who listens to our problem and explains properly.

  • Person Image

    I got diagnosed about a year back but was avoiding operation for Hernia repair, Dr Nitish Jhawar explained me why surgery should be done and I chose surgery by laparoscopy method. I am happy with the doctor and the hospital.

  • Person Image

    I visited for Gall Bladder removal by Laparoscopy after searching for best laparoscopic surgeon. After meeting dr my fear for surgery was vanished and my surgery went well and recovery was smooth.

  • Person Image

    Honest doctor, expert in his field....can trust his words

  • Person Image

    Very good he describe everything in very pleasant manner about the problem which was very helpful to me to understand my disease.

  • Person Image

    Very nice. Doctor is very patient and gives you correct advice.

  • Person Image

    He is very erudite and smart at getting to the bottleneck of the problem. And before realized he had pinched away d growth bothering me near my anal area.

  • Person Image

    Dr. Jhawar is few of the best doctors in town. Extremely pleasant and comfortable experience