by The Welthi Bureau | 26th, Oct, 2019
Do you tend to pass hard stools? Or strain excessively while passing stool? It may not be constipation, instead, you must be suffering from a condition called obstructive defecation syndrome. Yes, you have heard it right Obstructive defecation syndrome (ODS) can be termed as the inability to pass stool through the digestive tract out of the rectum. This might be characterized by the need to strain with bowel movements, multiple unproductive urges, incomplete emptying or sensation of a blockage. Dr.Roy Patankar, leading Gastroenterologist & Director of Zen Hospital will brief you about this condition.
1. What are the symptoms of obstructive defecation syndrome?
The most common symptom of obstructive defecation is the feeling of more stools remaining in the rectum after attempting to pass stool. Furthermore, the other symptoms may include straining to empty, passing hard stools, excessive or prolonged straining while passing stool, routine usage of laxatives or enemas, prolonged or unsuccessful efforts to evacuate a motion, long hours spent in the bathroom, a sensation of incomplete emptying or difficulty wiping clean.
2. What are the causes?
Failure to relax the anal sphincter or pelvic floor muscles while trying to defecate is a common functional cause of obstructive defecation which is also known as anismus or pelvic floor dyssynergia. Moreover, a weakness in the rectovaginal septum may also allow the rectum to push forward against the posterior vaginal wall and herniate. Some women tend to become aware of a bulge in the vagina,particularly towards the end of the day if they have been lifting or spent a lot of time standing. A hernia of the small bowel or sigmoid colon through the Pouch of Douglas can obstruct defecation and lead to difficulty with evacuation. Obstructive defecation can be caused by structural deformities due to hereditary, injury, or age, problems with your digestive tract, impacted stool, or neurologic issues.
3. What is the treatment?
Various treatment options are available for patients with ODS and imaging plays a very important role in deciding the optimal treatment strategy for a particular patient. If imaging does not reveal significant structural abnormalities, then the patient is offered conservative treatment like diet and lifestyle modifications and biofeedback therapy. You will be advised to opt for a healthy and well-balanced diet along with staying hydrated and drinking a lot of water. You must also see to it that you include fibre-rich foods in your diet to regulate your bowel movements. Moreover, the patients will also be prescribed stool softeners. You must pay attention towards your bowel movement, and cultivate the habit of visiting the loo regularly even with your hectic schedules. Not only this, pelvic floor physiotherapy is the first-line treatment for most patients and includes instruction about the positioning on the toilet, relaxation of the abdominal and pelvic floor muscles, avoiding straining and breath holding, and promoting correct techniques to allow unobstructed defecation.
One can be asked to undergo rectocele repair by the doctor. It is a standard posterior repair, sometimes with perineorrhaphy, is the most common procedure when patients complain of ODS and a bulge in the vagina secondary to a rectocele. One can also opt for Stapled transanal resection of the rectum which is a transanal approach and can be used to treat a rectocele and prolapsing rectal mucosa causing intussusception. Also, laparoscopic ventral rectopexy can be helpful as this is particularly suitable for women with a visible external prolapse of the rectum and obstructive defecation, although the operation can also be performed for those with intussusception on defecography.
For Appointment : Dr.Roy Patankar, leading Gastroenterologist & Director of Zen Hospital
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