Obstructed defaecation syndrome
Obstructed defaecation syndrome (ODS) refers to difficulty emptying the bowel, even when there is an urge to pass stools. It is a common condition that can significantly impact quality of life.
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What causes obstructed defaecation syndrome?
Obstructed defaecation can be caused by functional issues, physical abnormalities, or a combination of both:
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Functional causes – The pelvic floor fails to relax or tightens instead of releasing when trying to pass stools. This prevents smooth evacuation
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Physical causes – Weakness in the pelvic floor can lead to rectoceles, enteroceles, or internal prolapse (intussusception). These conditions create a physical blockage or form a pocket in the rectum, trapping stool and causing incomplete evacuation
Symptoms of obstructed defaecation syndrome
Symptoms may include:
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Straining excessively during bowel movements
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Feeling incomplete emptying even after passing stools
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Making frequent or fruitless visits to the toilet
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Using a finger to help evacuation (applying pressure near the vagina or rectum)
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Leakage of stool after using the toilet due to incomplete emptying
These symptoms can lead to discomfort, frustration, and a reduced quality of life.
Investigating obstructed defaecation syndrome
To confirm a diagnosis and identify the underlying cause, several investigations may be required:
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Flexible sigmoidoscopy or colonoscopy – To ensure there are no underlying bowel diseases
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Video proctogram – The most useful test, providing detailed images of bowel movement and pelvic floor function
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Transit study – Assesses how long food takes to move through the digestive system
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Anorectal physiology tests – Measures sphincter muscle function
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Endoanal ultrasound scan – Checks for muscle damage in the pelvic floor and rectum
Treatment for obstructed defaecation syndrome
Non-surgical management
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Many patients find relief through dietary and behavioural modifications, including:
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Keeping stools soft by increasing fibre and fluid intake
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Avoiding straining by adopting proper toilet posture
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Using glycerine suppositories to aid evacuation
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Biofeedback and physiotherapy – Help retrain pelvic floor muscles for better coordination during bowel movements
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Surgical treatment
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If a structural abnormality is causing symptoms, surgery may be required. Options include:
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Rectocele repair – Strengthens the rectal wall to prevent stool from being trapped
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Ventral mesh rectopexy – Used for enterocele or internal rectal prolapse, repositioning the rectum and reinforcing the pelvic floor
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Get in touch to make a private appointment request with the Rapid Access Bowl Clinic, or call our team on 0161 495 7046 who will be happy to help.