The most common cause leading to primary constipation is obstructed defecation syndrome (ODS). Anatomical disorders in the pelvic floor region (rectocele, enterocoele, rectal intussusception, and rectal prolapse) result in ODS. However, it always occurs in combination with a functional defect of defecation. This review offers an in-depth look at ODS diagnosis and treatment. Conservative or surgical treatment options are available. Conservative treatment includes several approaches to defecation practice and regimen and dietary measures combined with pelvic floor rehabilitation and psychological support. However, some patients require surgical intervention as ODS symptoms might persist despite conservative treatment. Surgical approaches include transvaginal, transabdominal, and transanal procedures. The most widely used are the transanal procedures, which are associated with good short-term results and low complication rates. Nevertheless, the long-term complications are still unknown and being discussed. The underlying cause of ODS is a combination of functional and anatomical abnormalities; therefore, treatment should be focused on pelvic organ systems for several reasons. Accordingly, only a multidisciplinary approach and (multimodal) combination of different approaches can be used to avoid inferior results in this challenging area.

Background The study objective was to compare health-related quality of life (HRQoL) between participants with Crohn's Disease (CD) and healthy controls (CONs). Methods A case-control study was conducted in adults with CD and CONs in Saudi Arabia (aged between 18-60 years). Sociodemographic data (age, sex, age at diagnosis) were collected. The following additional information was collected for the CD group: the onset of disease, treatment, and symptomology associated with CD. The validated Arabic version of the SF-36 was used to assess HRQoL. Results The study included 109 CD patients and 370 CON participants. Participants with CD had significantly lower HRQoL scores in the physical functioning [CD=75 (50-90) vs CON=85 (60-95)], role physical [CD=50 (0-100) vs CON=100 (50-100)], role emotional [CD=67 (0-100) vs CON= 67 (33-100)], vitality [CD= 50 (30-58) vs CON=50 (40-60)], social functioning [CD=63 (50-75) vs CON=75 (50-88)], bodily pain [CD=70 (45-90) vs CON=80 (68-100)], general health [CD=55 (40-65) vs CON=65 (55-75)], physical [CD=63 (52-75), vs CON=75 (63-85)], and mental domains [CD=51 (32-69) vs CON=63 (55-72)] than the CON group (p<0.02). In the CD group, participants with loss of appetite had lower HRQoL scores in the physical functioning [loss appetite=60 (40-80) vs no loss appetite=83 (65-90)], role physical [loss appetite=25 (0-75) vs no loss appetite=50 (25-100)], social functioning [loss appetite=63 (50-75) vs no loss appetite=75 (50-88)], physical [loss appetite=57 (45-68) vs no loss appetite=69 (56-78)], and mental domains [loss appetite=47 (30-67) vs no loss appetite=59 (44-72)] than participants without loss of appetite (p<0.04). Conclusion Individuals with CD had lower HRQoL than CON participants. Loss of appetite is associated with a lower HRQoL score.