What is obstructed defaecation syndrome (ODS)?
Obstructed defaecation refers to difficulty emptying the bowel, even when there is an urge to pass stools. It is a common condition that can significantly impact quality of life.
What causes obstructed defaecation syndrome?
Obstructed defaecation can be caused by functional issues, physical abnormalities, or a combination of both:
- Functional causes – The pelvic floor fails to relax or tightens instead of releasing when trying to pass stools. This prevents smooth evacuation
- Physical causes – Weakness in the pelvic floor can lead to rectoceles, enteroceles, or internal prolapse (intussusception). These conditions create a physical blockage or form a pocket in the rectum, trapping stool and causing incomplete evacuation
Symptoms of obstructed defaecation syndrome
Symptoms may include:
- Straining excessively during bowel movements
- Feeling incomplete emptying even after passing stools
- Making frequent or fruitless visits to the toilet
- Using a finger to help evacuation (e.g., applying pressure near the vagina or rectum)
- Leakage of stool after using the toilet due to incomplete emptying
These symptoms can lead to discomfort, frustration, and a reduced quality of life.
Investigating obstructed defaecation syndrome
To confirm a diagnosis and identify the underlying cause, several investigations may be required:
- Flexible sigmoidoscopy or colonoscopy – To ensure there are no underlying bowel diseases
- Video proctogram – The most useful test, providing detailed images of bowel movement and pelvic floor function
- Transit study – Assesses how long food takes to move through the digestive system
- Anorectal physiology tests – Measures sphincter muscle function
- Endoanal ultrasound scan – Checks for muscle damage in the pelvic floor and rectum
Treatment for obstructed defaecation syndrome
Non-surgical management
Many patients find relief through dietary and behavioural modifications, including:
- Keeping stools soft by increasing fibre and fluid intake
- Avoiding straining by adopting proper toilet posture
- Using glycerine suppositories to aid evacuation
- Biofeedback and physiotherapy – Help retrain pelvic floor muscles for better coordination during bowel movements
Surgical treatment
If a structural abnormality is causing symptoms, surgery may be required. Options include:
- Rectocele repair – Strengthens the rectal wall to prevent stool from being trapped
- Ventral mesh rectopexy – Used for enterocele or internal rectal prolapse, repositioning the rectum and reinforcing the pelvic floor
Why choose the Midlands Bowel Clinic?
- Specialist colorectal surgeons and pelvic floor experts
- Advanced diagnostic techniques, including video proctogram and anorectal physiology testing
- Minimally invasive surgical options for faster recovery
- Personalised treatment plans tailored to each patient’s condition
Contact us
If you experience difficulty emptying your bowels, excessive straining, or incomplete evacuation, contact us today to explore specialist diagnosis and treatment options.Bottom of Form
