Dyssynergic defecation: The not so hidden partner in constipation

Excerpt

Dyssynergic defecation (DD) is one of the commonest causes of chronic constipation (CC). It is primarily characterized by impaired rectal evacuation (paradoxical contraction and/or inadequate relaxation of the pelvic floor muscles and/or inadequate propulsive forces during attempted defecation), with normal or delayed colonic transit. In the West, the prevalence of DD among patients with CC ranges from 27% to 59% [1]. The gold standard for diagnosis relies on both symptoms and physiological testing. DD is also known to adversely affect the quality of life of patients; in particular, a study by Rao et al. reported that 69% and 76% of DD patients suffered from worse work life and social life, respectively [2]. When compared with patients with slow transit constipation, patients with DD had reported greater psychological distress and impaired health-related quality of life (QOL) [3]. …