Symptoms and Diagnosis of Constipation and Difficult Defecation

Patients suffering from constipation often mistake this condition for a temporary digestive issue and lose time with incorrect treatments for years. However, understanding whether constipation is due to anismus (pelvic muscle spasm) is the first step toward accurate treatment. This article explains the scientific diagnostic procedures performed within the scope of symptoms and diagnosis of constipation and difficult defecation.

Symptoms of Constipation Associated with Anismus

The following complaints indicate that constipation originates from pelvic floor muscle dysfunction rather than dietary habits:

• Spending an excessively long time in the toilet (30-60 minutes) and straining excessively.
• A sensation of blockage or obstruction in the anal area during defecation.
• Inability to feel relieved after defecation, experiencing a sense of incomplete evacuation.
• Having to press around the anus or provide manual support (digital maneuver) to facilitate stool passage.

Diagnostic Methods

Advanced pelvic diagnostic tests are utilized to diagnose anismus:

• Balloon Expulsion Test: The time required for the patient to expel a small water-filled balloon inserted into the rectum is measured. While it should normally be expelled within 1-2 minutes, patients with anismus fail to expel the balloon.
• High-Resolution Anal Manometry: A precise test that measures the pressure profile of the anal sphincter muscles and the contraction strength during defecation.
• MR Defecography: Dynamic imaging under MRI during defecation to observe whether the anorectal angle opens properly.