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After having looked at my sitzmark test my doc gave me a kind of "pre-diagnoses" of Obstructive Defecation and is sending me to a specialist. As usual she shuttled me out the door with out much of any explaination so I did some research on the net. I had run in to it previously while looking into IBS. But I thought it was a female only prob, usually after pregnancy. I guess I didn't read enough. I probably shouldn't be bothering asking this as this is probably just another dead end diagnoses like every one before it but I like to stay informed about what this stuff is. So if anyone has a some info or personal experiences about this it would be greatly appreciated if you shared them. Thanks.
 

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"The act of defecation requires a supportive tensioning of the "platform" pelvic floor muscles at the same time as relaxation of the "sling" muscle puborectalis and relaxation of the "outlet" anal sphincter muscles. If this evacuation sequence becomes "disordered" or if the lower end of the bowel loses tone and becomes baggy there is failure to evacuate the bowel satisfactorily. Women complain that they can feel a "lump" or "pressure" around the vagina or back passage and despite straining are unable to push the stool out."http://www.thegoodbowelhabit.com/page5.html"Patients with obstructive defecation showed impaired rectal contraction, paradoxical anal contraction, or inadequate anal relaxation. These features suggest that rectoanal coordination was impaired. Biofeedback therapy rectified these pathophysiological disturbances and improved constipation."http://www.blackwell-synergy.com/links/doi...98.00326.x/abs/
 

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obstructive defecation or outlet obstruction (another term) is caused by a malfunctioning of the muscles of the pelvic floor. Commonly people THINK they are pushing when trying to have a BM, but in reality, the muscles are doing the opposite...they are clenching and forcing the stools up higher into the rectum. Kinks in the colon (rectocele, sigmoidocele) also fall under the category. This occurs when a women has lots of pressure on her bowels (like pregnany) and it causes part of the bowel to collapse a bit. Excessive straining while trying to have a BM can also cause this.Biofeedback training is a new tool used to treat people with pelvic floor dysfunction and studies have show a 95% success rate. I would ask your doctor about that.Best of luck.-Maura
 
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