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Related Experiment Videos

Outlet Dysfunction Constipation.

Arnold Wald1

  • 1Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh, PA 15213, USA. walda@msx.upmc.edu

Current Treatment Options in Gastroenterology
|July 27, 2001
PubMed
Summary
This summary is machine-generated.

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Outlet dysfunction constipation diagnosis relies on tests like balloon expulsion and manometry when conservative treatments fail. Biofeedback is a low-risk, effective therapy for pelvic floor dyssynergia, though habit training also shows benefits.

Area of Science:

  • Gastroenterology
  • Colorectal Surgery
  • Pelvic Floor Disorders

Background:

  • Outlet dysfunction constipation is diagnosed when standard treatments like fiber and laxatives are ineffective.
  • Diagnostic testing is crucial for identifying the specific causes of constipation.
  • Pelvic floor dyssynergia is a potential diagnosis, but may be over-diagnosed.

Purpose of the Study:

  • To outline diagnostic methods for outlet dysfunction constipation.
  • To discuss therapeutic options for constipation related to pelvic floor dysfunction.
  • To emphasize the importance of experienced centers for diagnosis and treatment.

Main Methods:

  • Balloon expulsion studies are used for initial screening.
  • Anorectal manometry, electromyography, and barium defecography are employed for further diagnosis.

Related Experiment Videos

  • Pelvic floor dyssynergia is assessed if balloon expulsion is abnormal.

    • Main Results:

    • Anal sphincter electromyogram and manometry are comparable diagnostic tools.
    • Barium defecography can identify rectoceles, with functional improvement noted via vaginal pressure.
    • Manometry detects megarectum, hypotonia, and weak expulsion efforts.

    Conclusions:

    • Biofeedback training is a logical, low-risk treatment for pelvic floor dyssynergia, benefiting 60-80% of patients.
    • Habit training offers benefits but requires long-term reinforcement; laxatives and enemas are adjunctive.
    • Surgery and botulinum toxin injections are reserved for specific cases and carry risks; experienced centers improve outcomes.