Benign Colorectal Disease

  • Elisa H. Birnbaum


The incidence of benign medical and surgical diseases of the colon and rectum increases with age. Although constipation, fecal incontinence, and several other associated benign conditions increase in frequency with aging, a paucity of information exists regarding the normal aging effect on gastrointestinal pathophysiology. Studies documenting anatomic, physiologic, and pathologic changes that occur in the aging colon have not been definitive; and many studies have reported conflicting results. Mucosal atrophy, atrophy of circular muscles, thickening of longitudinal muscles (taeniae coli), increased elastin deposition, and atherosclerosis are several of the changes seen in the aging bowel.1 These changes may factor into the development of several disease states (i.e., diverticular disease and angiodysplasia). Myriad medications affect gastrointestinal function and many have constipation as a side effect. Preexisting diseases (cardiac, pulmonary, renal, neurologic, psychiatric) factor into the cause of several benign colorectal diseases, directly or secondarily, because of the medications used to treat the disease.


Fecal Incontinence Anal Sphincter Outlet Obstruction Rectal Prolapse Pudendal Nerve 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Whiteway J, Morson B. Pathology of the aging: diverticular disease. Clin Gastroenterol 1985;14:829–846.PubMedGoogle Scholar
  2. 2.
    Everhart JE, Go VL, Johannes RS, et al. A longitudinal survey of self-reported bowel habits in the United States. Dig Dis Sci 1989;34:1153–1162.PubMedCrossRefGoogle Scholar
  3. 3.
    Read NW, Celik AF, Katsinelos R Constipation and incontinence in the elderly. J Clin Gastroenterol 1995;20:61–70.PubMedCrossRefGoogle Scholar
  4. 4.
    Stewart RB, Moore MT, Marks RG, Hale WE. Correlates of constipation in an ambulatory elderly population. Am J Gastroenterol 1992;87:859–864.PubMedGoogle Scholar
  5. 5.
    Connell AM, Hilton C, Irvine G, et al. Variation of bowel habit in two population samples. Br Med J 1965;2:1095–1099.PubMedCrossRefGoogle Scholar
  6. 6.
    Milne JS, Williamson J. Bowel habit in older people. Gerontol Clin 1972;14:56–60.CrossRefGoogle Scholar
  7. 7.
    Donald IP, Smith RG, Cruikshank JG, et al. A study of constipation in the elderly living at home. Gerontology 1985;31:112–118.PubMedCrossRefGoogle Scholar
  8. 8.
    Harari D, Gurwitz JH, Minaker KL. Constipation in the elderly. J Am Geriatr Soc 1993;41:1130–1140.PubMedGoogle Scholar
  9. 9.
    Metcalf A, Phillips S, Zinsmeister A, et al. Simplified assessment of segmental colonic transit. Gastroenterology 1987; 92:40–47.PubMedGoogle Scholar
  10. 10.
    Melkersson M, Andersson H, Bosaeus I, Falkheden T. Intestinal transit time in constipated and nonconstipated geriatric patients. Scand J Gastroenterol 1983;18:593–597.PubMedCrossRefGoogle Scholar
  11. 11.
    Merkel IS, Locher J, Burgio K, et al. Physiologic and psychologic characteristics of an elderly population with chronic constipation. Am J Gastroenterol 1993;88:1854–1859.PubMedGoogle Scholar
  12. 12.
    Moore-Gillon V. Constipation: what does the patient mean? J R Soc Med 1984;77:108–110.PubMedGoogle Scholar
  13. 13.
    Johanson JF, Sonnenberg A, Koch TR. Clinical epidemiology of chronic constipation. J Clin Gastroenterol 1989;11: 525–536.PubMedCrossRefGoogle Scholar
  14. 14.
    Muller-Lissner SA. Effect of wheat bran on weight of stool and gastrointestinal transit time: a meta-analysis. Br Med J 1988;296:615–617.CrossRefGoogle Scholar
  15. 15.
    Campbell AJ, Busby WJ, Horwath CC. Factors associated with constipation in a community based sample of people aged 70 years and over. J Epidemiol Community Health 1993;47:23–26.PubMedCrossRefGoogle Scholar
  16. 16.
    Smith B. Effect of irritant purgatives on the myenteric plexus in man and the mouse. Gut 1968;9:139–143.PubMedCrossRefGoogle Scholar
  17. 17.
    Fleshman J, Dreznik Z, Meyer K, et al. Outpatient protocol for biofeedback therapy of pelvic floor outlet obstruction. Dis Colon Rectum 1992;35:1–7.PubMedCrossRefGoogle Scholar
  18. 18.
    Tjandra JJ, Fazio VW, Church JM, et al. Clinical conundrum of solitary rectal ulcer. Dis Colon Rectum 1992;35:227–234.PubMedCrossRefGoogle Scholar
  19. 19.
    Kuijpers HC, Schreve RH, ten Cate Hoedemakers H. Diagnosis of functional disorders of defecation causing the solitary rectal ulcer syndrome. Dis Colon Rectum 1986;29: 126–129.PubMedCrossRefGoogle Scholar
  20. 20.
    Altemeier WA, Culbertson WR, Schowengerdt C, Hunt J. Nineteen years’ experience with the one-stage perineal repair of rectal prolapse. Ann Surg 1971;173:993–1006.PubMedCrossRefGoogle Scholar
  21. 21.
    Williams JG, Rothenberger DA, Madoff RD, Goldberg SM. Treatment of rectal prolapse in the elderly by perineal rectosigmoidectomy. Dis Colon Rectum 1992;35:830–834.PubMedCrossRefGoogle Scholar
  22. 22.
    Watts JD, Rothenberger DA, Bulls JG, et al. The management of procidentia: 30 years’ experience. Dis Colon Rectum 1985;28:96–102.PubMedCrossRefGoogle Scholar
  23. 23.
    Kuijpers, HC. Treatment of complete rectal prolapse: to narrow, to wrap, to suspend, to fix, to encircle, to plicate or to resect? World J Surg 1992;16:826–830.PubMedCrossRefGoogle Scholar
  24. 24.
    McKee RF, Lauder JC, Poon FW, et al. A prospective randomized study of abdominal rectopexy with and without sigmoidectomy in rectal prolapse. Surg Gynecol Obstet 1992;174:145–148.PubMedGoogle Scholar
  25. 25.
    Ripstein CB. Treatment of massive rectal prolapse. Am J Surg 1952;83:68–71.PubMedCrossRefGoogle Scholar
  26. 26.
    Kuijpers JHC, DeMorree H. Toward a selection of the most appropriate procedure in the treatment of complete rectal prolapse. Dis Colon Rectum 1988;31:355–357.PubMedCrossRefGoogle Scholar
  27. 27.
    Berman IR. Sutureless laparoscopic rectopexy for procidentia: technique and implications. Dis Colon Rectum 1992;35: 689–693.PubMedCrossRefGoogle Scholar
  28. 28.
    Mikulicz J. Zur operativen behandlung des prolapsus recti et coli invaginati. Arch Klin Chir 1889;38:74–97.Google Scholar
  29. 29.
    Prasad ML, Pearl RK, Abcarian H, et al. Perineal proctectomy, posterior rectopexy, and postanal levator repair for the treatment of rectal prolapse. Dis Colon Rectum 1986; 29:547–552.PubMedCrossRefGoogle Scholar
  30. 30.
    Guyton DP, Evans D, Schreiber H. Stercoral perforation of the colon: concepts of operative management. Am Surg 1985;51:520–522.PubMedGoogle Scholar
  31. 31.
    Ballantyne GH, Brandner MD, Beart RW, Ilstrup DM. Volvulus of the colon; incidence and mortality. Ann Surg 1985;202:83–92.PubMedCrossRefGoogle Scholar
  32. 32.
    Habr Gama A, Haddad J, Simonsen O, Warde P, et al. Volvulus of the sigmoid colon in Brazil: a report of 230 cases. Dis Colon Rectum 1976;19:314–320.CrossRefGoogle Scholar
  33. 33.
    Ballantyne GH. Review of sigmoid volvulus: history and results of treatments. Dis Colon Rectum 1982;25:494–501.PubMedCrossRefGoogle Scholar
  34. 34.
    Bak MP, Boley SJ. Sigmoid volvulus in elderly patients. Am J Surg 1986;151:71–75.PubMedCrossRefGoogle Scholar
  35. 35.
    Hines JR, Geurkink RE, Bass RT. Recurrence and mortality rates in sigmoid volvulus. Surg Gynecol Obstet 1967;124: 567–570.PubMedGoogle Scholar
  36. 36.
    Arnold GJ, Nance FC. Volvulus of the sigmoid colon. Ann Surg 1973;177:527–533.PubMedCrossRefGoogle Scholar
  37. 37.
    Wolfer JA, Beaton LE, Anson BJ. Volvulus of the cecum: anatomical factors in its etiology; report of a case. Surg Gynecol Obstet 1942;74:882–894.Google Scholar
  38. 38.
    Rabinovici R, Simansky DA, Kaplan O, et al. Cecal volvulus. Dis Colon Rectum 1990;55:765–769.CrossRefGoogle Scholar
  39. 39.
    Todd GJ, Forde KA. Volvulus of the cecum: choice of operation. Am J Surg 1979;138:632–634.PubMedCrossRefGoogle Scholar
  40. 40.
    Nelson R, Norton N, Cautley E, Furner S. Community-based prevalence of anal incontinence. JAMA 1995;274: 559–561.PubMedCrossRefGoogle Scholar
  41. 41.
    Barrett JA, Brocklehurst JC, Kiff ES, et al. Anal function in geriatric patients with faecal incontinence. Gut 1989;30: 1244–1251.PubMedCrossRefGoogle Scholar
  42. 42.
    McHugh SM, Diamant NE. Effect of age, gender, and parity on anal canal pressures; contribution of impaired anal sphincter function to fecal incontinence. Dig Dis Sci 1987; 32:726–736.PubMedCrossRefGoogle Scholar
  43. 43.
    Bannister JJ, Abouzekry I, Read NW. Effect of aging on anorectal function. Gut 1987;28:353–357.PubMedCrossRefGoogle Scholar
  44. 44.
    Whitehead WE, Burgio KL, Engel BT. Biofeedback treatment of fecal incontinence in geriatric patients. J Am Geriatr Soc 1985;33:320–324.PubMedGoogle Scholar
  45. 45.
    Simmang C, Birnbaum EH, Kodner IJ, et al. Anal sphincter reconstruction in the elderly: does advancing age affect outcome? Dis Colon Rectum 1994;37:1065–1069.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2001

Authors and Affiliations

  • Elisa H. Birnbaum

There are no affiliations available

Personalised recommendations