Dyssynergic Constipation Symptoms: When to See a Doctor - Healthline

Constipation is when you don't poop as often as usual or strain when you do. It can be caused by a number of things such as a diet without enough fiber or certain medications, but it can also result from disruptions to your everyday routine.

About half of people who are chronically constipated have what's known as dyssynergic constipation.

When everything is working correctly, the muscles in your pelvic floor help to hold organs like your bladder or uterus in place while the muscles lower down in your abdomen push poop through. With dyssynergic constipation, the muscles don't work together properly and the result is dyssynergic defecation — improper clearing of the bowels.

Read on to learn more about the symptoms of dyssynergic constipation, as well as its causes and what you can do to remedy it.

People with dyssynergic constipation are unable to have bowel movements on a regular basis, usually defined as three or more times a week. You may also have to strain to poop, pass hard stools, or feel full even after pooping.

Some people even have to use their fingers to help things along, either by inserting them in the anus or pressing on their vagina, a technique known as vaginal splinting.

Dyssynergic constipation refers specifically to when the muscles in your pelvic floor don't work properly with the ones around your anus and rectum to help move poop along.

Other types of constipation can be caused by a diet low in fiber or certain medications, such as some pain relievers.

For some people, the inability to poop comes along with pregnancy, old age, inactivity, or dehydration. Stress or disruptions to your everyday schedule, like traveling or job changes, can also affect the routine of your bowel movements.

It's not totally clear what causes dyssynergic constipation, although there are some common elements among people who have it.

Research has found that almost one-third of people with dyssynergic constipation have had it since childhood, while almost as many thought it started happening after pregnancy or a back injury.

People who have conditions that affect how nerves and muscles communicate, such as myasthenia gravis or multiple sclerosis, may also have dyssynergic constipation.

A history of sexual or physical abuse also appears to increase someone's chances of developing it.

There are several different tests doctors can use to help diagnose dyssynergic constipation:

• Magnetic resonance imaging (MRI). MRI scans can help your doctor see if there is any tissue or organ damage that's making it harder for you to have a bowel movement.
• Blood tests. Your doctor may order some blood work to rule out other causes of constipation, but slightly more invasive tests are usually required.
• Sigmoidoscopy. Doctors may use a finger or sigmoidoscope, a small camera at the end of a flexible tube, to examine the lower part of your colon.
• Anorectal manometry. In an anorectal manometry, a balloon is inserted in your anus and inflated to simulate a stool while doctors see how well your bowels move it along. Barium paste may be used instead of a balloon. Doctors monitor your response to the pressure with instruments or watch how easily you pass it.
• Colonic transit time exam. In this test, you take capsules with special markers in them. Then, your doctor will order an X-ray of your intestines over the course of a few days. With this, doctors can see how quickly and easily things are moving through your system.

If you are pooping fewer than three times a week or have to insert a finger or use vaginal pressure to move poop along, you should schedule an appointment with a doctor.

You'll also want to see a healthcare professional if you:

• have blood in your stool
• strain so hard to poop that your back starts to hurt
• feel like you need to poop right after having a bowel movement

While some people may feel embarrassed to have conversations with a doctor about this subject, constipation can cause serious problems if left untreated.

Complications include:

A healthcare professional will be able to help you find relief, and that is what's important.

Biofeedback is the most common treatment for this condition, but there are a few other things you can try.

Biofeedback

Biofeedback is a therapy where sensors are placed around your body to help measure how you react to certain stimuli. It's been shown to help people learn how to train their bodies to overcome dyssynergic constipation.

Research finds that biofeedback is effective for more than 60% of people with dyssynergic constipation.

Therapists can use the information gained from biofeedback to suggest exercises to help restore strength and control to the muscles responsible for moving poop through your system.

Another goal of biofeedback can be to restore proper sensation in the rectum, so you can evacuate your bowels promptly and feel empty afterward.

Biofeedback is considered a noninvasive and pain-free treatment.

Dietary changes

Many people with constipation aren't including enough fiber in their diet.

Eating more whole grains, vegetables, and legumes can help poop move more easily through your intestines. Fiber supplements may also help.

Medication changes

Certain medications, like opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), and antacids, can cause constipation. You may want to speak with your doctor about reducing the medications or finding alternatives.

Adding laxatives or stool softeners may be helpful.

Botox injections

Injections of botulinum toxin — Botox — may help relax the pelvic floor muscles.

Exercises

A physical therapist can prescribe specific exercises to help you strengthen and gain control of the muscles that help move poop through your intestines.

Dyssynergic constipation can be incredibly uncomfortable and disruptive to your life, but there are safe, pain-free, reliable ways to deal with it.

Speak with a doctor if you're having trouble with your bowel movements more than a couple of times a week.