Treatment of Difficult/Obstructive Defecation
- 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.
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Last updated: January 26, 2022
Zutshi, Massarat, and Lucia C Castro Oliveira. "Treatment of Difficult/Obstructive Defecation." ASCRS Textbook of Colon and Rectal Surgery, 2022. ASCRS U, www.ascrsu.com/ascrs/view/ASCRS-Textbook-of-Colon-and-Rectal-Surgery/2285055/all/Treatment_of_Difficult_Obstructive_Defecation.
Zutshi M, Castro Oliveira LC. Treatment of Difficult/Obstructive Defecation. ASCRS Textbook of Colon and Rectal Surgery. 2022. https://www.ascrsu.com/ascrs/view/ASCRS-Textbook-of-Colon-and-Rectal-Surgery/2285055/all/Treatment_of_Difficult_Obstructive_Defecation. Accessed June 8, 2023.
Zutshi, M., & Castro Oliveira, L. C. (2022). Treatment of Difficult/Obstructive Defecation. In ASCRS Textbook of Colon and Rectal Surgery https://www.ascrsu.com/ascrs/view/ASCRS-Textbook-of-Colon-and-Rectal-Surgery/2285055/all/Treatment_of_Difficult_Obstructive_Defecation
Zutshi M, Castro Oliveira LC. Treatment of Difficult/Obstructive Defecation [Internet]. In: ASCRS Textbook of Colon and Rectal Surgery. ; 2022. [cited 2023 June 08]. Available from: https://www.ascrsu.com/ascrs/view/ASCRS-Textbook-of-Colon-and-Rectal-Surgery/2285055/all/Treatment_of_Difficult_Obstructive_Defecation.
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