Pelvic floor dyssynergia
Chronic constipation affects 11%-18% of the population, with a female-to-male ratio of almost 2:1. Of patients with chronic constipation, 25%-50% of them have pelvic floor issues. A significant number of patients will report having had issues since childhood. A history of sexual abuse and mood disorders also seem to be related to defecation difficulties.
Patients will present with complaints of difficulty passing stool, only passing small amounts of stool per sitting, incomplete emptying, infrequent bowel movements, a need for regular laxative use, and backache.
If this is chronic enough, some patients may have rectal incontinence as well. Patients may also report that they have to digitally evacuate stool.
Diagnostic criteria include having functional constipation symptoms for at least 12 weeks, evidence of dyssynergic pattern on defecography, and at least 2 other abnormal colorectal tests showing impaired evacuation.
K59.09 – Other constipation
14760008 – Constipation
Differential Diagnosis & Pitfalls