This cross-sectional study investigated the prevalence of chronic constipation post total laryngectomy (TL) and after total pharyngolaryngectomy (TPL). For the study, the authors used a self-completed patient questionnaire to evaluate the prevalence and factors related to it. Patients using opioids, anticholinergic drugs, Eastern Cooperative Oncology Group Performance States (ECOG PS) 2 or higher and currently hospitalised patients were excluded from the study. The authors report an incidence of constipation of 47.1% after total laryngectomy versus 12.5% after total laryngopharyngectomy. They found that dietary factors, use of nutritional supplements and exercise habits were not significantly associated with chronic constipation. They propose that patients with total laryngectomy may have difficulties with breath holding and so, may be prone to the development of chronic constipation. They speculate that patients with total laryngopharyngectomy had pharyngeal reconstruction with free jejunal flap which caused food bolus to flow into the stomach stimulating secretion of gastric acid. Excessive gastric acid can inactivate digestive pancreatic enzymes causing malabsorption of fat and a tendency to diarrhea which may reduce constipation in patients with TPL. The authors’ hypothesis is interesting. Prospective studies in future can help to confirm their results.
Post-total laryngectomy constipation
Reviewed by Gauri Mankekar
Total laryngectomy increases the risk of chronic constipation: a cross-sectional study of 50 patients.
CONTRIBUTOR
Gauri Mankekar
Department of Otolaryngology-Head Neck Surgery, Louisiana State University Shreveport, Louisiana, USA.
View Full Profile
