How to recover from dyssynergistic defectation / obstructed defecation
April 12, 2021 11:00 AM Subscribe
I've done a lot of physical therapy for dyssynergistic defecation/ obstructed defecation / pelvic floor dysfunction. PT has helped but I'm not fully recovered. Have any of you had a similar experience and found other things have helped?
Hi everyone,
I'm wondering if anyone has experience with dyssynergistic defecation/ obstructed defecation / pelvic floor dysfunction (It's basically a condition where your pelvic floor muscles don't relax as they should and your stool tends to become stuck in your rectum). I have a question about recovering from this condition:
First my story:
I was diagnosed with this condition by anorectal manometry last November, as described in this article (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4930297). Since then I've received biofeedback therapy / training to use my pelvic floor muscles properly (https://sci-hub.do/10.1023/a%3A1018846113210). Mercy Baltimore (https://mdmercy.com/centers-of-excellence/digestive-health-and-liver-disease) has an advanced setup with high-resolution intrarectal and anal pressure monitoring. They charge something like $500 per 1-hour session, and my insurance doesn't cover it. Johns Hopkins physical therapy and InBalance Physical Therapy (https://www.inbalancephysicaltherapy.com/) have a less advanced setup with voltage monitoring of the anal sphincter and with my insurance they come to $70 per 1-hour session. I was also able to rent a basic voltage biofeedback unit (https://www.cmtmedical.com/product/pathway-tr-20/) for $100/month. For cost reasons, I've mainly worked with Hopkins and InBalance, and I've improved my performance voltage-wise (I can keep my anal voltage < 1.7 uV pretty much all the time and do maneuvers like quick squeezes and long holds and relax immediately thereafter). I've also improved my symptoms. I used to have several nights a week where I had to use saline enemas to reduce my abdominal pain so that I could sleep. In the last 2 months, I've had 2 nights where that happened, and several nights where I was wake 1 or 2 hours past my bedtime to have a bowel movement so that I could sleep.
I also follow a low FODMAP diet, log my diet in MyFitnessPal, and work with a nutritionist. I eat about 40 g of fiber a day, mostly from low FODMAP vegetables, so I know my constipation isn't from low fiber.
I've also had hydrogen breath testing to rule out SIBO.
So overall I'm doing much better. But I'm not fully recovered yet. I think it could be I'm not doing a good job of using my abdominal muscles like the transversus abdominis to increase intrarectal pressure (as described in https://sci-hub.do/10.1023/a%3A1018846113210), and my physical therapists think that's plausible. So they've taught me a lot of core exercises like the dead bug (https://www.healthline.com/health/exercise-fitness/dead-bug-exercise) which strengthen transversus abdomenis. Besides doing exercises like these, do any of you have other things which you've found found helpful in your experience?
Hi everyone,
I'm wondering if anyone has experience with dyssynergistic defecation/ obstructed defecation / pelvic floor dysfunction (It's basically a condition where your pelvic floor muscles don't relax as they should and your stool tends to become stuck in your rectum). I have a question about recovering from this condition:
First my story:
I was diagnosed with this condition by anorectal manometry last November, as described in this article (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4930297). Since then I've received biofeedback therapy / training to use my pelvic floor muscles properly (https://sci-hub.do/10.1023/a%3A1018846113210). Mercy Baltimore (https://mdmercy.com/centers-of-excellence/digestive-health-and-liver-disease) has an advanced setup with high-resolution intrarectal and anal pressure monitoring. They charge something like $500 per 1-hour session, and my insurance doesn't cover it. Johns Hopkins physical therapy and InBalance Physical Therapy (https://www.inbalancephysicaltherapy.com/) have a less advanced setup with voltage monitoring of the anal sphincter and with my insurance they come to $70 per 1-hour session. I was also able to rent a basic voltage biofeedback unit (https://www.cmtmedical.com/product/pathway-tr-20/) for $100/month. For cost reasons, I've mainly worked with Hopkins and InBalance, and I've improved my performance voltage-wise (I can keep my anal voltage < 1.7 uV pretty much all the time and do maneuvers like quick squeezes and long holds and relax immediately thereafter). I've also improved my symptoms. I used to have several nights a week where I had to use saline enemas to reduce my abdominal pain so that I could sleep. In the last 2 months, I've had 2 nights where that happened, and several nights where I was wake 1 or 2 hours past my bedtime to have a bowel movement so that I could sleep.
I also follow a low FODMAP diet, log my diet in MyFitnessPal, and work with a nutritionist. I eat about 40 g of fiber a day, mostly from low FODMAP vegetables, so I know my constipation isn't from low fiber.
I've also had hydrogen breath testing to rule out SIBO.
So overall I'm doing much better. But I'm not fully recovered yet. I think it could be I'm not doing a good job of using my abdominal muscles like the transversus abdominis to increase intrarectal pressure (as described in https://sci-hub.do/10.1023/a%3A1018846113210), and my physical therapists think that's plausible. So they've taught me a lot of core exercises like the dead bug (https://www.healthline.com/health/exercise-fitness/dead-bug-exercise) which strengthen transversus abdomenis. Besides doing exercises like these, do any of you have other things which you've found found helpful in your experience?
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posted by MexicanYenta at 9:35 AM on April 15, 2021