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Diagnostic Criteria for Dyssynergic Defecation (6,7):
Patients must satisfy the diagnostic criteria for functional chronic constipation (Rome III) and
Patients must have dyssynergic pattern of defecation (Types 1–4), which 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 based on manometry (8), radiologic imaging or EMG.
Patients must satisfy one or more of the following criteria*:
Inability to expel an artificial stool (50 ml water filled balloon) within one to two minutes.
Inability to evacuate or ≥50% retention of barium during defecography.
*Some laboratories use 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 radiopaque marker capsule containing 24 radio opaque markers.