Chronic, Severe Constipation (Dyssynergic Defecation) Treated at Mercy

Constipation is generally described as having fewer than three bowel movements a week. Chronic constipation is infrequent bowel movements or difficult passage of stools that persists for several weeks or longer.

Though occasional constipation is very common, some people experience chronic constipation that can interfere with their ability to go about their daily tasks.

Dyssynergic defecation is common and affects up to one half of patients with chronic constipation. This acquired behavioral problem is due to the inability to coordinate the abdominal and pelvic floor muscles to evacuate stools.

Symptoms of constipation vary, and each individual may experience symptoms differently, however, the most common symptoms include:

• Difficult and painful bowel movements
• Bowel movements fewer than three times a week
• Feeling bloated or uncomfortable
• Feeling sluggish
• Abdominal pain

Doctors may use a variety of diagnostic options when assessing chronic constipation including:

• Complete and thorough medical exam including patient history
• Blood tests
• X-ray
• Sigmoidoscopy
• Colonoscopy
• Anorectal manometry
• Balloon expulsion test
• Keeping a stool diary
• Colonic transit study

For more severe cases or cases where dyssynergic defecation is suspected, a digital rectal exam may be recommended.

Most often, constipation can be treated through dietary and lifestyle changes. Other options include the use of laxatives or eliminating or changing medication.

For patients with constipation that is not relieved by common first-step strategies, a motility specialist may provide further insight into the condition and offer highly-specialized treatment to address and resolve the issue.

In cases of dyssynergic defecation, biofeedback bowel retraining is recommended as a first-line treatment due to its proven effectiveness.