Medical and Surgical Therapy for Constipation in Patients with Cerebral Palsy Erin A. Teeple, Roberto A. Gomez Suarez, and Charles D. Vinocur Contents Introduction .............................................................................. 2 Natural History .......................................................................... 2 Physiopathology .......................................................................... 2 Treatment ................................................................................ 2 History and Physical Exam ............................................................... 2 Abdominal Radiography ................................................................. 4 Sitz Marker Study ........................................................................ 4 Motility Studies ........................................................................... 5 Rectal Biopsies ........................................................................... 6 Medical Therapy .......................................................................... 6 Retrograde Enemas and Fecal Disimpaction ............................................. 6 Antegrade Enteral Cleanout at Home .................................................... 8 Admission for Bowel Cleanout .......................................................... 8 Maintenance Therapy ..................................................................... 8 Diet ........................................................................................ 8 Medications that Induce Constipation .................................................... 9 Complications ............................................................................ 9 Surgical Therapy and Interventions ...................................................... 9 Medically Refractory Constipation ....................................................... 10 Volvulus ................................................................................... 11 Perforation ................................................................................ 12 E. A. Teeple (*) · C. D. Vinocur Department of Surgery, Nemours/A.I. Dupont Hospital for Children, Wilmington, DE, USA e-mail: Erin.teeple@nemours.org; Charles. vinocur@nemours.org R. A. Gomez Suarez Department of Gastroenterology, Nemours Children’ s Hospital, Orlando, FL, USA e-mail: Roberto.gomezsuarez@nemours.org # Springer Nature Switzerland AG 2019 F. Miller et al. (eds.), Cerebral Palsy , https://doi.org/10.1007/978-3-319-50592-3_54-1 1