BCM Gastroenterology Grand Rounds - Take Home Lessons
The main lessons to take home concerning this case are:
|
1.
Failure of
the pelvic floor and anal muscles to relax during straining
(pelvic floor dysfunction) is the commonest cause of obstructed defecation. |
|
2.
Anorectal
manometry with anal sphincter EMG is useful in diagnosing pelvic floor
dysfunction by demonstrating inappropriate sphincter contraction during
defecation. |
|
3.
Biofeedback
is reported to benefit more than half of patients with evidence of
pelvic floor dyssynergia, but mechanisms of action are still
unclear and controlled studies are lacking. |