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We read with interest the paper by Kamm and coworkers on the effect of sacral stimulation on intractable constipation.1 The paper reports the results of an open multicentre study on the effect of this procedure in patients who proved refractory to the standard medical treatments of constipation. We think that some biases limit the application of the study to real-life patients with constipation.
First, the authors correctly report that, in the original paper of the Rome III commission, functional constipation was defined only by the presence of at least two out of five different symptoms.2 A reduced number of bowel movements was simply one of the …
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