[Defecometry: determination of objective parameters of defecation]

Area of Science:

• Gastroenterology
• Physiology
• Neurology

Context:

• Constipation is a common condition affecting many individuals.
• Difficult rectal evacuation remains a poorly understood aspect of constipation.
• Existing diagnostic techniques have limitations in elucidating this specific defecation disorder.

Purpose:

• To introduce and validate a novel method for identifying and analyzing constipation caused by difficult rectal evacuation.
• To investigate the physiological mechanisms underlying disturbed defecation in affected patients.

Summary:

• A new method successfully identified difficult rectal evacuation in 5 out of 19 constipated patients.
• This condition is characterized by prolonged simulated stool evacuation and increased work performed.
• The primary cause identified is paradoxical pelvic floor contraction instead of relaxation during defecation.

Impact:

• The findings highlight that excessive straining during defecation can lead to neuromuscular damage of the pelvic floor.
• This diagnostic method clarifies the principle that early therapeutic intervention is crucial for managing this condition.
• Early diagnosis and treatment can prevent long-term pelvic floor dysfunction and improve patient outcomes.