26/08/2020
Functional defecation disorders (FDD) encompass causes of constipation associated with anore**al dysfunction, which
include dyssynergia or inadequate defecatory propulsion FDD are frequently encountered in clinical practice and may
affect up to 33–50% of patients with chronic constipation. The etiology of FDD is unclear,however,it has been defined as
an acquired, but subliminal behavioral disorder Pathophysiologic mechanisms may include discoordination of rectoa**l
muscles, paradoxical contraction or insufficient relaxation of pubore**alis and/or a**l sphincter during defecation, and
sluggish colonic transit. A combination of comprehensive clinical assessment, digital re**al examination and a battery of
physiologic tests are needed to make an accurate diagnosis of FDD Defecography may play a crucial role in the evaluation
of FDD, especially when a balloon expulsion test (BET) and/or anore**al manometry (ARM) are equivocal or demonstrate
contradictory results. In this review, we provide a thorough overview of the epidemiology, pathophysiology, diagnostic
criteria, clinical and imaging evaluation, and treatment options for FDD, with an emphasis on available diagnostic imaging
tools such as defecography and conventional fluoroscopic methods
https://lnkd.in/e28dphz