Constipation and defecation disorders represent some common clinical condition in the Western world, especially in the field of female healthcare. During the last ten years, their impact on the quality of life and on the patients’ daily activities has been largely discussed in the Scientific Literature due to its high incidence, complex pathophysiology, and the absence of a consensus regarding the definitions, diagnostic work-up and therapeutic planning.

Particularly, the defecation disorders include complex and heterogeneous disabling clinical conditions represented by a marked difficulty in fecal evacuation, characterized by fragmented stools, need for straining at defecation, sensation of incomplete evacuation, tenesmus, urgency, pelvic heaviness and self-digitation. Quite frequently also fecal incontinence is associated.

The health care costs of constipation in USA are estimated to be significant as evidenced by the hundreds of million dollars spent yearly on laxatives alone.

A correct diagnostic framework and a multidisciplinary management can to lead an optimal functional result and a better quality of life.

Prof. Carlo Ratto graduated  in Medicine and Surgery at the Catholic University of Rome in 1987, and specialized in Emergency Surgery at the Catholic University of Rome in 1992. He is a colorectal surgeon, experienced in clinical and scientific research, training and educational support, and innovations in Coloproctology. His clinical practice concerns particularly the colo-recto-anal disorders and diseases. He was coordinator of several scientific projects, with the publication of results on prestigious scientific journals and editor of books on different topics in Coloproctology. Scientific Director and Member of Board of numerous training and master courses, meetings, and congresses. He  has been  frequently involved, as invited speaker, in a number of National and  International Congresses and Meetings, performing also “live surgery”.He is active member of the American Society of Colon and Rectal Surgeons (ASCRS), Fellow, and member  of the InternationalCommittee;  European Society of Coloproctology (ESCP); Italian Society of Colorectal Surgery (SICCR) and International Anal Neoplasia Society (IANS). He serves on the Editorial Board of the following scientific Journals: Techniques in Coloproctology and World Journal of Gastroenterology and is a member of the Editorial Advisory Board of Colorectal Disease Journal.

Dr. Angelo Parello graduated with honors in Medicine and Surgery at the Catholic University of Rome, where he also got his specialization in General Surgery. His clinical practice is mainly focused on the  diagnosis and treatment of colo-rectal-anal diseases, and he is an expert in performing both ano-rectal and pelvic floor diagnostics tests and treatments. He collaborated in the development of a novel minimally invasive surgical approach to treat fecal incontinence - THD implant Gatekeeper and SphinKeeper - now available for use all around the  world. 
He was teacher and tutor in many national and international courses conducted in Italy and in other European Countries, and an  active member of the Italian Society of Colorectal Surgery (SICCR); in 2007-2008  he was a member of the Guidelines commission on behalf of this Society. 
He is author of several scientific publications on international journals,   of several chapters in books, and presented results of his research at national and international scientific conferences.

Dr. Francesco Litta   graduated in Medicine and Surgery Rome with first class honours (110/110 cum laude). at the Catholic University, he became a specialist in General Surgery in the same university. He is an attending physician at the Proctology Unit of the Foundation University Hospital “A. Gemelli”, Rome, Italy, directed by Prof. Carlo Ratto.  His clinical practice focuses mainly on the diagnosis and treatment of disease of the colon and the rectum, and all proctological diseases. His research activity  is mainly based on the evaluation and treatment of patients affected by fecal incontinence, constipation, anal fistula, hemorrhoidal disease, obstructed defecation, inflammatory bowel diseases   with studies concerning the pathophysiology and the surgical treatment by means of traditional and new minimally-invasive therapeutic options. He is author of several scientific publications on international journals, of several chapters in books, and presented results of his research at national and international scientific conferences. He is teacher in a series of national and international courses on the management of coloproctologic diseases. He is active member of the Italian Society of Colorectal Surgery (SICCR).

Dr. Veronica  De Simone    graduated in Medicine and Surgery at the Catholic University of Rome   with first class honours (110/110 cum laude) and was resident in GeneralSurgery at the same university. She works at the Proctology Unit of the Foundation University Hospital “A. Gemelli”, Rome, Italy, directed by Prof. Carlo Ratto. 
Her clinical practice concerns the diagnosis and treatment of  benign and malignant colorectal and anal diseases.  She is also involved in multidisciplinary team for the diagnosis, treatment and follow up of patients affected by rectal and anal cancer. Her research activity is mainly based on the evaluation and treatment of patients affected by fecal incontinence, anal HPV-related diseases and ano-rectal disfunctional outcomes after rectal resection surgery.
She is author of several scientific publications on international journals and presented results of her research at national and international scientific conferences. She is teacher in a series of national and international courses on the diagnosis and treatment of colorectal diseases and active member of the Italian Society of Colorectal Surgery (SICCR) and of the International Anal Neoplasia Society (IANS).

Dr. Paola Campennì  graduated cum laude in Medicine and Surgery at the University of Rome La Sapienza   with an experimental research about transanal endoscopic microsurgery for rectal cancer. She worked as a resident in Digestive Surgery Unit at the University of Udine, and later  she focused on colorectal diseases and minivasive surgery at the University of Milan. She  concluded her surgical training with honors and the scientific publication of degree thesis. She is now a staff surgeon of the Proctology Unit of the Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome and she is manly dedicated to treatment of chronic inflammatory bowel, pelvic disorders, proctological diseases.  She is author of several papers concerning functional disorders and rectal cancer.  From 2016 to 2019 she worked at Humanitas Research Hospital, Rozzano (MI) as colorectal surgeon and at Humanitas University as tutor of Medicine and Surgery students (course of SimulationLab: patients management). She is one of the founders of Young Group of Italian Society of Colorectal Surgery (SICCR-Y), secretary from 2017 to 2019 and promoter of numerous scientific activities and international courses. 

Dr. Angelo Alessandro Marra  graduated in Medicine and Surgery   and specialized in General Surgery  at the Catholic University of the Sacred Heart, Rome, Italy. He spent his residency period at the Proctology Unit of the Foundation University Hospital “A. Gemelli” IRCSS, Rome, Italy, directed by Prof. Carlo Ratto. Actually, he is PhD student in Experimental and Translational Medicine at the Catholic University  of Rome  and practices clinical activity at Proctology and Pelvic Floor Surgery Unit of the Fatebenefratelli Isola Tiberina – Gemelli Isola, Rome, Italy. Since 2018, he showed a particular interest in Coloproctology and Pelvic Floor diseases. He is author of several publications on national and international peer-reviewed journals and book chapters in this field. He is involved as a teacher in multiple national and international courses on the diagnosis and treatment of anorectal and pelvic floor diseases. He is an active member of the European Society of Colo-Proctology (ESCP).