Obstructed Defaecation Syndrome

Obstructed defaecation simply means having difficulty emptying the bowel.

What causes obstructed defaecation?

There are two causes of obstructed defaecation, functional causes and physical causes. Sometimes the two can co-exist:

  • Functional - in this situation the pelvic floor fails to relax or even tightens when a patient tries to open their bowel.
  • Physical causes - these are caused by weakness in the pelvic floor rectoceles, enteroceles and internal prolapse (intussusception). These cause either a physical blockage to evacuation, or result in a pocket forming which traps some bowel content meaning evacuation is incomplete.


Symptoms of Obstructed Defaecation Syndrome (ODS)

The symptoms experienced include some or all of the following:

  • Needing to strain
  • Never feeling empty
  • Frequent visits to the lavatory
  • Fruitless visits to the lavatory
  • Using a finger to help evacuation

As emptying may not be complete some patients describe leakage of a small amount of stool after they have been to the lavatory.


Investigating Obstructed Defaecation Syndrome (ODS)

Before confirming the diagnosis and finding a cause for obstructed defaecation, patients will require some form of endoscopic examination of the bowel either by flexible sigmoidoscopy or colonoscopy to ensure that it is otherwise healthy.

The most useful test to determine the cause of obstructed defaecation is a video proctogram. This gives information not only about structural problems but also whether or not the pelvic floor works properly.

A transit study is often also performed.

Most patients will also have tests of their sphincter muscle function (anorectal physiology) and an endoanal ultrasound scan to look for any damage to the muscle.


Obstructed Defaecation Syndrome (ODS) Treatment

Keeping the stools soft, avoiding straining and the use of glycerine suppositories will help many patients.
Where the problem is due to function then biofeedback / physiotherapy is usually recommended to enable patients to regain co-ordination of their pelvic floor.

If a physical cause for the symptoms is found surgical correction may be recommended. Such procedures might include a rectocele repair or ventral mesh rectopexy for patients with enterocele or internal prolapse.


What our Patients think :

What are the next steps?

If you think you have this condition or any of these symptoms you will need to seek medical advice.

For more information or to make an appointment:

If you have private medical care or wish to pay to see a consultant:

Take this factsheet along to your own GP and request a referral to one of our consultants.