Dyssynergic defecation may aggravate constipation: results of mostly pediatric cases with congenital anorectal malformation

Am J Surg. 2015 Aug;210(2):357-64. doi: 10.1016/j.amjsurg.2014.09.038. Epub 2015 Jan 31.

Abstract

Background: Most patients with congenital anorectal malformation suffer from mild chronic constipation. To date, it is unclear why a subgroup of patients develops a persistent form of constipation. Because dyssynergic defecation is a common cause of constipation in the general population, we hypothesized that the severe form of constipation may be caused by dyssynergic defecation.

Methods: Retrospectively, we reviewed the medical records of 29 patients with anorectal malformations who had undergone anorectal function tests because of severe constipation. The study was conducted at the University Medical Center Groningen, The Netherlands.

Results: All patients had increased maximum rectal pressure and increased anal sphincter pressure during balloon expulsion and therefore suffered from dyssynergic defecation.

Conclusions: Patients with congenital anorectal malformations may also suffer from dyssynergic defecation. It is important, therefore, to check whether these patients have severe constipation due to dyssynergic defecation because perhaps it may be treated effectively with pelvic physiotherapy.

Keywords: Anorectal anomaly; Anorectal function test; Defecation disorders; Pelvic floor dyssynergia.

MeSH terms

  • Adolescent
  • Adult
  • Anorectal Malformations
  • Anus, Imperforate / complications*
  • Anus, Imperforate / physiopathology*
  • Child
  • Constipation / etiology*
  • Constipation / physiopathology*
  • Defecation*
  • Female
  • Humans
  • Male
  • Retrospective Studies
  • Severity of Illness Index
  • Young Adult