Anismus

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Anismus
Synonyms	Dyssynergic defecation, Paradoxical puborectalis contraction
Pronounce	N/A
Specialty	N/A
Symptoms	Constipation, straining during bowel movements, incomplete evacuation
Complications	Fecal impaction, rectal prolapse
Onset	Can occur at any age
Duration	Chronic
Types	N/A
Causes	Dysfunction of the pelvic floor muscles
Risks	Pelvic surgery, neurological disorders, psychological factors
Diagnosis	Anorectal manometry, defecography, balloon expulsion test
Differential diagnosis	Irritable bowel syndrome, rectocele, anal fissure
Prevention	N/A
Treatment	Biofeedback therapy, pelvic floor physical therapy, botulinum toxin injection
Medication	Laxatives (for symptom relief)
Prognosis	N/A
Frequency	Common, but exact prevalence is unknown
Deaths	N/A

Anismus is a functional disorder where the sphincter muscle in the rectum does not relax properly during defecation, leading to difficulty in passing stool. This condition is also known as paradoxical puborectalis contraction or spastic pelvic floor syndrome.

Stylized depiction of action of puborectalis sling

Symptoms

The main symptom of anismus is difficulty in passing stool, despite the urge to defecate. Other symptoms may include:

• Constipation
• Straining during bowel movements
• Feeling of incomplete evacuation
• Abdominal pain
• Bloating

Causes

The exact cause of anismus is unknown. However, it is believed to be related to the improper functioning of the nerves and muscles in the rectum. Some possible causes include:

• Nerve damage
• Pelvic floor dysfunction
• Psychological stress
• Childbirth

Diagnosis

Diagnosis of anismus is usually made based on the patient's symptoms and medical history. Additional tests may be performed to confirm the diagnosis, such as:

• Anorectal manometry
• Defecography
• Electromyography

Treatment

Treatment for anismus focuses on improving the coordination of the pelvic floor muscles. This may include:

• Biofeedback therapy
• Physical therapy
• Medication
• Surgery

See also

• Pelvic floor
• Rectal prolapse
• Fecal incontinence

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