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CRITERIA FOR DYSSYNERGIC DEFECATION (modified from Ref. 48,12)
Patients must satisfy the diagnostic criteria (Ref. 75) for functional chronic constipation (Rome III) and
Patients must demonstrate dyssynergia during repeated attempts to defecate.
A dyssynergic or obstructive pattern of defecation (Types 1–4), is defined as paradoxical increase in anal sphincter pressure (anal contraction) or less than 20% relaxation of the resting anal sphincter pressure or inadequate propulsive forces observed with manometry, imaging or electromyographic recordings and
One or more of the following criteria during repeated attempts to defecate
Inability to expel an artificial stool (50 ml water-filled balloon) within one minute.
A prolonged colonic transit time, i.e. greater than 5 markers (≥20% marker retention) on a plain abdominal x-ray taken 120 hours after ingestion of one sitzmark® capsule containing 24 radio opaque markers.
Inability to evacuate or ≥50% retention of barium during defecography.