title: Dyssynergic defecation may aggravate constipation: results of mostly pediatric cases with congenital anorectal malformation.
abstract: BACKGROUND
  Most patients with congenital anorectal malformation suffer from mild chronic constipation. To date, it is unclear why a subgroup of patients develops a persistent form of constipation. Because dyssynergic defecation is a common cause of constipation in the general population, we hypothesized that the severe form of constipation may be caused by dyssynergic defecation.
  
  
  METHODS
  Retrospectively, we reviewed the medical records of 29 patients with anorectal malformations who had undergone anorectal function tests because of severe constipation. The study was conducted at the University Medical Center Groningen, The Netherlands.
  
  
  RESULTS
  All patients had increased maximum rectal pressure and increased anal sphincter pressure during balloon expulsion and therefore suffered from dyssynergic defecation.
  
  
  CONCLUSIONS
  Patients with congenital anorectal malformations may also suffer from dyssynergic defecation. It is important, therefore, to check whether these patients have severe constipation due to dyssynergic defecation because perhaps it may be treated effectively with pelvic physiotherapy.
authors.affiliation: Department of Surgery, Anorectal Physiology Laboratory, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. Electronic address: m.van.meegdenburg02@umcg.nl.
authors.forename: Maxime M
authors.initials: MM
authors.lastname: van Meegdenburg
authors.affiliation: Department of Surgery, Division of Pediatric Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Erik
authors.initials: E
authors.lastname: Heineman
authors.affiliation: Department of Surgery, Anorectal Physiology Laboratory, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Department of Surgery, Division of Pediatric Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Paul M A
authors.initials: PM
authors.lastname: Broens
mesh_terms: D000293:Adolescent; D000328:Adult; D000071056:Anorectal Malformations; D001006:Anus, Imperforate / Q000150:complications* / Q000503:physiopathology*; D002648:Child; D003248:Constipation / Q000209:etiology* / Q000503:physiopathology*; D003672:Defecation; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index; D055815:Young Adult
keywords: Anorectal anomaly; Anorectal function test; Defecation disorders; Pelvic floor dyssynergia