Key Concepts

• Obstructed defecation syndrome is a subtype of constipation wherein patients usually complain of straining; incomplete, unsuccessful, or painful evacuation; bowel infrequency; abdominal pain and bloating; and the possible need for digitation.
• Initial management is lifestyle advice, laxatives, and bowel retraining programs, including biofeedback and psychological support.
• Diagnostic testing may point to a diagnosis, but clinical correlation should always be used.
• Dyssynergic defecation is a clinical diagnosis and requires knowledge of anatomy and physiology for management.
• Patients with overt rectal or anterior compartment prolapse and symptoms of obstructed defecation should be managed surgically.
• Rectoceles, when symptomatic, require a surgical option.
• Enteroceles and sigmoidoceles need a multimodal approach for effective symptom relief.