Dyssynergic Defecation and Biofeedback Therapy

Rao, Satish S.

doi:10.1016/j.gtc.2008.06.011

Cited by 200 publications

(263 citation statements)

References 76 publications

(102 reference statements)

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“…All these patterns are characterized by paradoxical contraction or a failure of anal relaxation (Fig. 2) 38 : a paradoxical increase in anal pressure with (type I) or without (type II) an adequate increase in rectal pressure and impaired anal relaxation with (type III) or with-out (type IV) an adequate increase in rectal pressure.…”

Section: Types Of Pelvic Floor Dyssynergiamentioning

confidence: 99%

How to Perform and Interpret a High-resolution Anorectal Manometry Test

Lee

Bharucha

2015

J Neurogastroenterol Motil

156

155

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High-resolution anorectal manometry (HR-ARM) and high-definition anorectal manometry (HD-ARM) catheters have closely spaced water-perfused or solid state circumferentially-oriented pressure sensors that provide much better spatiotemporal pressurization than non-high resolution catheters. This is a comprehensive review of HR-ARM and HD-ARM anorectal manometry catheter systems, the methods for conducting, analyzing, and interpreting HR-ARM and HD-ARM, and a comparison of HR-ARM with non-high resolution anorectal manometry. Compared to non-high resolution techniques, HR-ARM and HD-ARM studies take less time and are easier to interpret. However, HR-ARM and HD-ARM catheters are more expensive and fragile and have a shorter lifespan. Further studies are needed to refine our understanding of normal values and to rigorously evaluate the incremental clinical utility of HR-ARM or HD-ARM compared to non-high resolution manometry.

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Section: Types Of Pelvic Floor Dyssynergiamentioning

confidence: 99%

How to Perform and Interpret a High-resolution Anorectal Manometry Test

Lee

Bharucha

2015

J Neurogastroenterol Motil

156

155

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“…1 Preston and Lennard-Jones 2 first described the association of paradoxical anal contraction during attempted defecation in patients with constipation and coined the term "anismus". Subsequently, several terms have been used to describe this entity, including anismus, pregnancy, 14 and neurological diseases including Parkinson's disease and multiple sclerosis 15 have high prevalence of constipation.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and Treatment of Dyssynergic Defecation

Rao

Patcharatrakul

2016

J Neurogastroenterol Motil

195

149

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Dyssynergic defecation is common and affects up to one half of patients with chronic constipation. This acquired behavioral problem is due to the inability to coordinate the abdominal and pelvic floor muscles to evacuate stools. A detailed history, prospective stool diaries, and a careful digital rectal examination will not only identify the nature of bowel dysfunction, but also raise the index of suspicion for this evacuation disorder. Anorectal physiology tests and balloon expulsion test are essential for a diagnosis. Newer techniques such as high-resolution manometry and magnetic resonance defecography can provide mechanistic insights. Recently, randomized controlled trials have shown that biofeedback therapy is more effective than laxatives and other modalities, both in the short term and long term, without side effects. Also, symptom improvements correlated with changes in underlying pathophysiology. Biofeedback therapy has been recommended as the first-line of treatment for dyssynergic defecation. Here, we provide an overview of the burden of illness and pathophysiology of dyssynergic defecation, and how to diagnose and treat this condition with biofeedback therapy.

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“…The pattern of the dyssynergic defecation is not obvious etiologically. But the abnormal activity of this muscles is related to dysfunction of the brain-bowel axis, an impaired defecation pattern learned, or because the mechanisms of coordination for defecation never learnt during childhood [3].…”

Section: Introductionmentioning

confidence: 99%