, the abnormal contraction of the external anal sphincter and puborectalis muscle during attempted defecation, is another problem that can occur in synergy with constipation in approximately 65% of PD patients, which is more frequently observed during "off" periods [16, 28, 47].
The "'Biofeedback treatment in chronically constipated patients with dyssynergic defecation", article aimed to evaluate the effects of psychophysiological measures (EMG-activity during straining to defecate and anismus
index), as well as in clinical variables on chronically constipated patients with dyssynergic defecation.
However, the most common of the evacuatory disorders is pelvic floor dysfunction or anismus
If the anal sphincters and pelvic floor muscles contract rather than relax when receiving the urge stimulus, defecation cannot occur, which is called anismus or anorectal dyssynergia.
Whether or not resolving these issues will solve constipation, it is fundamental to start here when there is no evidence of obstruction, impaction or anismus.
Inability to expel the balloon suggests anismus
or pelvic floor dysfunction.
Roughly 50% of all cases of chronic constipation are due to a failure of coordination between the pelvic floor muscles and the anal sphincter--a condition called dyssynergic defecation or anismus
There are many different diagnoses associated with CPP including vulvar pain syndromes, interstitial cystitis, levator ani syndrome, piriformis syndrome, vaginismus, anismus
, dyspareunia, proctalgia fugax, constipation, pelvic floor tension myalgias, endometriosis, pudendal neuralgia, and/or rectal pain.
They concluded that treatment of the rectocele is not necessary once the abnormality has been corrected, such as intrarectal prolapse or anismus.
49] The primary symptom reported by patients with anismus is obstructed defecation.
Functional constipation that stems from abnormalities in the structure of the anus and rectum is known as anorectal dysfunction, or anismus
Results show significant improvements in psychophysiological measures (EMG-activity during straining to defecate and anismus
index), as well as in clinical variables.