Obstructive Defecation


What is obstructive defecation?

Obstructive defecation is one component of constipation. It is a common condition in which a person is unable to evacuate their bowels properly. This might be characterized by the need to strain with bowel movements, multiple unproductive urges, incomplete emptying or sensation of a blockage. Some individuals may also experience accidental bowel leakage.


What causes obstructive defecation?

The cause of Obstructive defecation can be associated to structural abnormalities such as a rectocele and internal or external rectal prolapse. It can also be associated to the inability to coordinate the pelvic floor muscles to relax properly, to produce a bowel movement.


How is obstructive defecation diagnosed?

Patients undergo a thorough medical history and rectal exam. A colonoscopy may be recommended to rule out rare causes of obstructive defecation. Anorectal manometry, electromyography (EMG) and defecography x-ray is done at the Pelvic Floor Center. These tests assess the strength and coordination of the muscles surrounding the anus, and shows what happens internally in the pelvis during defecation.  Additionally, the movement of the rectum, vagina and pelvic floor muscles can be seen during defecation.


How is obstructive defecation treated?

Treatment may include multiple interventions for optimal outcomes. Biofeedback therapy may help to retrain the pelvic floor muscles to allow for easier passage of stool. If your tests reveal a structural abnormality, surgical repair may be indicated.