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Reged: 12/09/02
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Loc: Seattle, WA
Dyssynergic Defecation: Demographics, Symptoms, Stool Patterns, and Quality of Life
      09/12/04 03:35 PM

Dyssynergic Defecation: Demographics, Symptoms, Stool Patterns, and Quality of Life.

Journal of Clinical Gastroenterology. 38(8):680-685, September 2004.

Rao, Satish S. C MD, PhD, FRCP(L) *; Tuteja, Ashok K MD *+; Vellema, Tony BS *; Kempf, Joan RN *; Stessman, Mary RN *

To understand the nature of bowel disturbance in patients with dyssynergia (chronic constipation due to a failure of coordination between the pelvic floor muscles and the anal sphincter, characterized by difficulty or inability to expel stool from the anorectum), we prospectively examined demographics, stool patterns, and quality of life by administering a 31-item questionnaire to 120 patients who fulfilled symptomatic and manometric criteria for dyssynergia (Rome II). Data from 118 subjects (M/F = 27/91) was analyzed.

Eighty four percent of patients reported excessive straining, and 76% reported feeling of incomplete evacuation; 9.7% had no urge to defecate. Abdominal bloating was reported by 74%. More women than men reported infrequent bowel movements and need to strain excessively (P < 0.05). Forty eight percent of patients, more women (P < 0.05) than men used digital maneuvers to evacuate. Hard stools was reported by 60% of women and 41% of men.

Sexual abuse was reported by 22%; 21% were women (P = 0.02). Physical abuse was reported by 32%. Bowel problem adversely affected family life in 33%, sexual life in 56%, work life in 69% and social life in 76% of patients. Most patients with dyssynergia reported an excessive need to strain, feeling of incomplete evacuation and abdominal bloating and one half used digital maneuvers. It significantly affected quality of life, particularly in women.

(C) 2004 Lippincott Williams & Wilkins, Inc.

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