Dyssynergic Defecation: Demographics, Symptoms, Stool... : Journal of Clinical Gastroenterology (original) (raw)

Alimentary Tract: Clinical Research

Dyssynergic Defecation: Demographics, Symptoms, Stool Patterns, and Quality of Life

Rao, Satish S. C MD, PhD, FRCP(L)*; Tuteja, Ashok K MD*†; Vellema, Tony BS*; Kempf, Joan RN*; Stessman, Mary RN*

From the *Department of Medicine, Division of Gastroenterology, University of Iowa College of Medicine, Iowa City, Iowa and from the †VA Salt Lake Health Care System, Salt Lake City, Utah.

Received for publication August 19, 2003;

accepted December 9, 2003.

Reprints: Satish SC Rao, MD, Division of Gastroenterology/Hepatology University of Iowa 4612 JCP 200 Hawkins Drive Iowa City, IA 52242 (e-mail: [email protected]).

Abstract

To understand the nature of bowel disturbance in patients with dyssynergia, we prospectively examined demographics, stool patterns, and quality of life by administering a 31-item questionnaire to 120 patients who fulfilled symptomatic and manometric criteria for dyssynergia (Rome II). Data from 118 subjects (M/F = 27/91) was analyzed. Eighty four percent of patients reported excessive straining, and 76% reported feeling of incomplete evacuation; 9.7% had no urge to defecate. Abdominal bloating was reported by 74%. More women than men reported infrequent bowel movements and need to strain excessively (P < 0.05). Forty eight percent of patients, more women (P < 0.05) than men used digital maneuvers to evacuate. Hard stools was reported by 60% of women and 41% of men. Sexual abuse was reported by 22%; 21% were women (P = 0.02). Physical abuse was reported by 32%. Bowel problem adversely affected family life in 33%, sexual life in 56%, work life in 69% and social life in 76% of patients. Most patients with dyssynergia reported an excessive need to strain, feeling of incomplete evacuation and abdominal bloating and one half used digital maneuvers. It significantly affected quality of life, particularly in women.