Defecatory disorders (DD), which commonly cause chronic constipation, are diagnosed by clinical features supplemented by abnormal anorectal tests, and should be managed by pelvic floor retraining by biofeedback therapy rather than by laxatives. DD are attributed to "maladaptive" pelvic floor contraction during defecation. This paradigm overlooks the contribution of visceral disturbances (e.g., increased anal resting pressure or anal hypertension). Biofeedback therapy is not widely available and there are no pharmacological approaches to manage DD currently. Anorectal tests are not widely available, and the accuracy of a key diagnostic test, i.e. a negative rectoanal gradient (rectal

Public Health Relevance

Defecatory disorders (DD) commonly cause chronic constipation. Our studies have the potential to refine diagnostic tests for DD, uncover a mechanism responsible for DD, and identify a new medication for DD, which are currently managed by pelvic floor retraining by biofeedback therapy that is not widely available.

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
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Special Emphasis Panel (ZRG1-DKUS-N (03))
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Hamilton, Frank A
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Mayo Clinic, Rochester
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