Obstructed Defecation

What is obstructed defecation?

Obstructed defecation is a type of constipation which can result in excessive straining to defecate and unsatisfactory bowel emptying, despite adequate stool type. The obstruction can either be functional i.e. pelvic floor muscles contracting rather than relaxing (dyssynergia), or structural i.e. pelvic organ prolapse.

Many people who experience obstructed defecation have failed previous attempts of treatment, often reporting that laxatives do not help. This can often lead people to experience feelings of stress, anxiety, and depression These emotions can also drive the pelvic floor muscles to be tight and non-relaxing and interrupt the gut-brain-pelvic floor connection.

How is obstructed defecation diagnosed?

Obstructed defecation can typically be diagnosed based on findings from a thorough history and a physical examination. Your Pelvic Physiotherapist will complete a thorough assessment of your pelvic floor to determine your best management plan. The physical examination may include a digital rectal examination or ultrasound assessment.

How is obstructed defecation treated?

Treatment for obstructed defecation is often multidisciplinary. This team may include a Colorectal Surgeon, Gastroenterologist, Pelvic Physiotherapist, Dietitian, and Psychologist.

Physiotherapy treatment may include;

• Adjunctive therapies utilising biofeedback (ultrasound, EMG & Rectal Balloon therapy). Biofeedback has been demonstrated to be an effective, first-line intervention for dyssynergia
• Pelvic floor muscle (PFM) relaxation including breathing exercises to relax your nervous system and PFM
• Optimising defecation technique including your toileting position, use of abdominal and pelvic floor muscles, and passive support/splinting if prolapse is relevant for you
• Stool manipulation through changes to dietary fibre, fluid intake, and laxatives. This will be in conjunctive with your medical team
• Lifestyle modifications including physical activity, weight loss, sleep hygiene, and overall relaxation
• Referral into our wonderful Pelvic Floor Release Workshop or Pelvic Yoga. These services are hybrid, allowing you to access them in studio or online

If you experience unsatisfactory bowel motions, get in touch with our friendly admin team or book your consultation today. Start your journey of healing with our expert physiotherapy team at the Sydney Pelvic Clinic.