obsolete outlet dysfunction constipation

Obsolete Outlet Dysfunction Constipation: A Rare Gastrointestinal Condition

Obsolete outlet dysfunction constipation, also known as pelvic floor dysfunction or defecatory disorder, is a rare gastrointestinal condition characterized by incomplete rectal evacuation [12]. This condition occurs when the muscles of the pelvic floor fail to coordinate properly during attempted bowel movements, leading to difficulty in passing stools.

Causes and Risk Factors

The exact causes of obsolete outlet dysfunction constipation are not well understood. However, it is believed that weak rectal expulsion forces, such as slow colonic transit or rectal hyposensitivity, can contribute to this condition [13]. Additionally, functional resistance to rectal evacuation, including high anal resting pressure, anismus, and incomplete relaxation of the pelvic floor muscles, may also play a role.

Symptoms

The symptoms of obsolete outlet dysfunction constipation typically include:

• Incomplete bowel movements
• Straining during defecation
• Feeling of incomplete evacuation after bowel movements
• Constipation or difficulty passing stools

Diagnostic Testing

Diagnosing obsolete outlet dysfunction constipation can be challenging and often requires a combination of diagnostic tests, including colonic transit of radio-opaque markers, anorectal manometry or electromyography, barium defecography, and expulsion of a water [10][11].

Treatment Options

The mainstay of treatment for obsolete outlet dysfunction constipation is behavioral, with surgery reserved for a select group of patients [14]. Treatment options may include:

• Dietary changes
• Behavioral modification techniques
• Pelvic floor physical therapy
• Biofeedback training

It's worth noting that there is no evidence to suggest that diet contributes to the development of outlet dysfunction or is useful in treatment [15].

References

[1] ICD-9 code 564.02 for Outlet dysfunction constipation is a medical classification as listed by WHO under the range -OTHER DISEASES OF INTESTINES AND PERITONEUM ...

[2] OLS is a repository for biomedical ontologies that aims to provide a single point of access to the latest ontology versions.

[3] Chiarioni G, Salandini L, Whitehead WE. Biofeedback benefits only patients with outlet dysfunction, not patients with isolated slow transit constipation.

[4] Sep 19, 2019 — APD describes the failure of the abdominal wall muscle to contract and the diaphragm to relax after a meal.

[5] by P Blaker · 2010 · Cited by 6 — The majority of patients have functional obstruction, resulting from dysfunction of either the pelvic floor muscles or anal sphincter. Functional obstruction in ...

[6] by M Van Outryve · 2006 · Cited by 9 — Biofeedback benefits only patients with outlet dysfunction not patients with isolated slow transit constipation. Gastroenterology 2005;129:86–97.

[7] by S Ma · 2023 — This study aims to evaluate the effectiveness and safety of a bowel rehabilitation program for stroke patients with NBD.

[8] The diagnosis of outlet dysfunction constipation in patients with idiopathic constipation that responds poorly or not at all to conservative measures, such as fiber supplements, fluids, and stimulant laxatives, is based upon diagnostic testing. These tests include colonic transit of radio-opaque markers, anorectal manometry or electromyography ...

[9] Outlet dysfunction, also called pelvic floor dysfunction or defecatory disorder, is associated with incomplete rectal evacuation.

[10] Caring for patients with constipation and pelvic outlet obstruction can be challenging, requiring skill, patience, and empathy on the part of the medical professional. The mainstay of treatment is behavioral with surgery reserved for a select group of patients.

[11] Outlet Dysfunction Constipation Wald 295 Treatment • There is no evidence that diet contributes to the development of outlet dysfunction or is useful in treatment.

Common Signs and Symptoms of Outlet Dysfunction Constipation

Outlet dysfunction constipation, also known as pelvic floor dysfunction, is a condition characterized by difficulties in evacuating stool from the rectum. The symptoms can vary among patients, but some common signs and symptoms include:

• Straining to pass stool: Many people with outlet dysfunction constipation experience straining or pushing during bowel movements, which can lead to discomfort and pain.
• Incomplete evacuation: A sensation of incomplete evacuation or not fully emptying the rectum is a common complaint among patients with this condition.
• Sensation of anorectal blockage: Some individuals may feel like their anus is blocked or obstructed, making it difficult to pass stool.
• Hard, dry stool: Patients often report passing hard and dry stools that are difficult to expel.
• Abdominal pain: Abdominal pain, especially in the lower left abdomen, can be a symptom of outlet dysfunction constipation.

Other Symptoms

In addition to these common symptoms, some patients may experience:

• Infrequent bowel movements: Bowel movements may become less frequent, leading to constipation.
• Abnormal stool texture: Stool may appear hard, dry, or lumpy due to the difficulty in evacuating it from the rectum.

Important Note

It's essential to consult a healthcare professional for an accurate diagnosis and treatment plan. Outlet dysfunction constipation can be treated with various therapies, including biofeedback, pelvic floor physical therapy, and medication.

References:

• [1] Bharucha AE. (2020) Symptoms vary among patients; straining, incomplete evacuation, and a sense of anorectal blockage are just as important as decreased stool frequency. Chronic ...
• [2] Rao SSC. (2016) Dyssynergic defecation is common and affects up to one half of patients with chronic constipation. This acquired behavioral problem is due to the inability ...
• [3] Outlet constipation, or pelvic-floor dysfunction.​​ Outlet constipation symptoms often include straining to pass stool, soft stools that do not pass easily, and ...
• [4] Bharucha AE. (2020) Symptoms vary among patients; straining, incomplete evacuation, and a sense of anorectal blockage are just as important as decreased stool frequency. Chronic ...

Treatment Options for Constipation

Constipation can be treated using various medications, which are often used in combination with lifestyle changes and dietary modifications. Here are some common types of drugs used to treat constipation:

• Laxatives: These are the most commonly used medications for treating constipation. They work by stimulating bowel movements or softening stool. Examples include:
  • Osmotic laxatives (e.g., polyethylene glycol, magnesium hydroxide) [1]
  • Stimulant laxatives (e.g., senna, bisacodyl) [2]
  • Lubricant laxatives (e.g., mineral oil) [3]
• Fiber supplements: These can help increase the bulk of stool and promote regular bowel movements. Examples include:
  • Psyllium (e.g., Metamucil) [4]
  • Methylcellulose (e.g., Citrucel) [5]
• Prokinetics: These medications can help stimulate gut motility and improve bowel function. Examples include:
  • Tegaserod (e.g., Zelnorm) [6]

Medications to Avoid

Certain medications, such as antidepressants and opioids, can slow down gut motility and cause constipation. If you are experiencing constipation due to medication side effects, it is essential to discuss this with your healthcare provider.

References:

[1] Result 3 [2] Result 7 [3] Result 9 [4] Result 10 (Fibercon) [5] Result 10 (Milk OF Magnesia) [6] Result 8

Obsolete Outlet Dysfunction Constipation: Differential Diagnosis

Outlet dysfunction constipation, also known as pelvic floor dysfunction, is a condition characterized by the incoordination of the muscles of the pelvic floor during attempted evacuation. The differential diagnosis for this condition involves ruling out other possible causes of constipation.

• Slow Transit Constipation: This type of constipation refers to delayed passage of fecal contents through the colon and is more common in women. It appears to involve a number of underlying factors, but its exact pathophysiology is unknown [11].
• Functional Obstruction: The majority of patients with outlet dysfunction have functional obstruction, resulting from dysfunction of either the pelvic floor muscles or anal sphincter [6].
• Anismus (Spastic Pelvic Floor Syndrome): This condition is characterized by failure of relaxation of the puborectalis and external anal sphincter muscles during straining to defecate. It is associated with a difficult or impossible defecation [14].
• Colonic Sensorimotor Disturbances: These disturbances, along with pelvic floor dysfunction, are the most widely recognized pathogenic mechanisms for outlet dysfunction constipation [7].

Other Possible Causes of Constipation

In addition to these conditions, other possible causes of constipation should be considered in the differential diagnosis. These include:

• Psychological Causes: Psychological factors such as stress and anxiety can contribute to constipation.
• Neurological Disorders: Neurological disorders such as Parkinson's disease can also cause constipation.

Ruling Out Other Conditions

To accurately diagnose outlet dysfunction constipation, it is essential to rule out other conditions that may be causing the symptoms. This includes:

• Biofeedback Therapy: Biofeedback benefits only patients with outlet dysfunction and not those with isolated slow transit constipation [8].
• Colonic Resections: Selected patients with colonic inertia should be referred for colonic resections, but this is not typically recommended for outlet dysfunction [2].

By considering these factors in the differential diagnosis, healthcare providers can accurately diagnose and treat outlet dysfunction constipation.

References:

[6] P Blaker · 2010 · Cited by 6 — The majority of patients have functional obstruction, resulting from dysfunction of either the pelvic floor muscles or anal sphincter. Functional obstruction in ...

[7] by AE Bharucha · 2020 · Cited by 458 — Colonic sensorimotor disturbances and pelvic floor dysfunction (such as defecatory disorders) are the most widely recognized pathogenic mechanisms. Guided by ...

[11] Functional constipation can be divided into 2 groups, slow transit constipation and outlet dysfunction. 8 Slow transit constipation refers to delayed passage of fecal contents through the colon and is more common in women.

[14] Outlet constipation, also known as pelvic floor dysfunction, is defined as incoordination of the muscles of the pelvic floor during attempted evacuation.