How is Dyssynergic Defecation Treated?
Dyssynergic defecation is effectively treated with education and neuromuscular training (biofeedback). The doctor will begin by reviewing past strategies, which may have been used by the patient in trying to treat their constipation. The future treatment plan will depend on what underlying factors may now be contributing to the chronic constipation.
Standard Treatment – Different remedies may have been tried, with little success, to relieve symptoms prior to being diagnosed with dyssynergic defecation.
Coexisting issues that are present in addition to the dyssynergic defecation still need to be addressed to move forward with successful treatment. For example, a review of all medicines and supplements being taken is important to identify any that may be constipating.
There is little evidence that changes in diet and exercise will improve chronic constipation. However, a balanced diet, adequate fiber (20 to 30 grams per day), and regular exercise promote good health in general.
When and how often to attempt bowel movements are important issues.
- Whenever possible, one should always respond to the urge to have a bowel movement, rather than hold it back.
- The body has internal mechanisms that naturally stimulate the bowel after waking and after meals. One can take advantage of this by attempting bowel movements, at least twice a day, about 30 minutes after meals.
- When attempting a bowel movement, it is important not to strain too long (no more than 5 minutes) nor push too much (no more than about one-half effort).
- Digital or manual maneuvers to empty stool from the rectum should be stopped.
- Bowel re-training involves sitting on the toilet for 15 to 20 minutes at the same time each day so the body can get into the habit of having regular bowel movements.
A doctor may recommend laxatives in order to help change stool consistency or movement through the bowel. Several types of laxatives are available. Bulk forming laxatives (fiber supplements), along with stool softeners and osmotic laxatives such as magnesium compounds or polyethylene glycol (Miralax, Glycolax), change stool consistency. Stimulant laxatives cause rhythmic muscle contractions in the bowel to propel stool. All are available without prescription, but for chronic constipation should be taken under a doctor’s guidance. Linaclotide (Linzess) and lubiprostone (Amitiza) are two prescription drugs for the treatment of chronic constipation in adults.
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