Anismus: Symptoms, Causes, Treatment

What are the symptoms of anismus?

Anismus, also known as pelvic floor dyssynergia or obstructive defecation syndrome, is a condition characterized by difficulty or inability to evacuate stool from the rectum due to dysfunction of the pelvic floor muscles. Symptoms of anismus can include:

1. Difficulty passing stool: Individuals with anismus often experience a sensation of incomplete evacuation or the need for prolonged straining during bowel movements.
2. Constipation: Chronic constipation is a common symptom of anismus, as the inability to effectively expel stool can lead to fecal impaction and difficulty passing stool.
3. Pain or discomfort: Straining during bowel movements can cause pain or discomfort in the rectum or pelvic area.
4. Rectal bleeding: Straining and trauma to the rectum caused by repeated attempts to pass stool can lead to rectal bleeding.
5. Abdominal bloating or discomfort: Chronic constipation and incomplete evacuation of stool can result in abdominal bloating or discomfort.
6. Fecal incontinence: In some cases, anismus can lead to fecal incontinence, or the involuntary loss of stool.
7. Urinary symptoms: Some individuals with anismus may also experience urinary symptoms, such as difficulty emptying the bladder completely or frequent urination.

Symptoms of anismus can vary in severity and may be intermittent. It’s important for individuals experiencing these symptoms to seek evaluation by a healthcare professional, as anismus can be associated with underlying conditions such as pelvic floor dysfunction, nerve damage, or structural abnormalities of the pelvic organs. A proper diagnosis is essential for determining the appropriate treatment approach.

What are the causes of anismus?

Anismus, or pelvic floor dyssynergia, can have various causes, including:

1. Pelvic floor muscle dysfunction: Anismus is often caused by dysfunction of the pelvic floor muscles, which play a crucial role in bowel movements. In some cases, the pelvic floor muscles may contract rather than relax during attempted bowel movements, leading to difficulty or inability to evacuate stool.
2. Neurological disorders: Conditions that affect the nerves controlling the pelvic floor muscles, such as multiple sclerosis, Parkinson’s disease, or spinal cord injury, can result in anismus.
3. Structural abnormalities: Structural abnormalities of the pelvic organs, such as rectal prolapse, rectocele, or intussusception, can contribute to anismus by obstructing the passage of stool.
4. Psychological factors: Stress, anxiety, or other psychological factors can affect bowel function and contribute to anismus.
5. Chronic constipation: Chronic constipation can lead to changes in bowel habits and pelvic floor muscle function, increasing the risk of developing anismus.
6. Previous surgery: Pelvic surgery, particularly surgery involving the rectum or pelvic floor, can disrupt normal bowel function and contribute to anismus.
7. Childbirth: In women, childbirth can lead to stretching or injury of the pelvic floor muscles, which can contribute to anismus.
8. Medications: Certain medications, such as opioids, anticholinergics, or tricyclic antidepressants, can affect bowel function and contribute to anismus.
9. Idiopathic: In some cases, the underlying cause of anismus may be unknown (idiopathic).

Treatment for anismus focuses on addressing the underlying cause and may include pelvic floor muscle training, biofeedback, dietary modifications, medications, or surgery, depending on the individual case. It’s important for individuals experiencing symptoms of anismus to seek evaluation by a healthcare professional for proper diagnosis and treatment.

What is the treatment for anismus?

The treatment for anismus, or pelvic floor dyssynergia, depends on the underlying cause and severity of the condition. Treatment options may include:

1. Pelvic floor muscle training: Pelvic floor physical therapy, also known as biofeedback, can help individuals learn how to relax and coordinate their pelvic floor muscles during bowel movements. This can be particularly effective for individuals with anismus due to pelvic floor muscle dysfunction.
2. Dietary modifications: Making changes to your diet, such as increasing fiber intake, drinking plenty of water, and avoiding foods that can contribute to constipation, can help improve bowel function and reduce symptoms of anismus.
3. Medications: In some cases, medications such as laxatives, stool softeners, or muscle relaxants may be prescribed to help manage symptoms of anismus.
4. Bowel retraining: Bowel retraining involves establishing a regular bowel movement schedule and using relaxation techniques to help improve bowel function.
5. Surgery: In cases where an underlying structural abnormality is causing anismus, surgery may be necessary to correct the issue.
6. Botulinum toxin injections: In some cases, injections of botulinum toxin into the pelvic floor muscles can help relax the muscles and improve bowel function.
7. Psychological therapy: For individuals with anismus related to psychological factors, such as stress or anxiety, therapy or counseling may be beneficial.
8. Management of underlying conditions: Treating underlying conditions such as neurological disorders or structural abnormalities can help improve symptoms of anismus.

Treatment for anismus is often tailored to the individual based on their specific symptoms and underlying cause. It’s important for individuals experiencing symptoms of anismus to seek evaluation by a healthcare professional for proper diagnosis and treatment.

How is anismus different from obstructed defecation syndrome?

Anismus and obstructed defecation syndrome (ODS) are related conditions that both involve difficulty with bowel movements, but they are distinct in terms of their underlying causes and symptoms:

1. Anismus: Anismus, also known as pelvic floor dyssynergia, is a condition characterized by dysfunction of the pelvic floor muscles, specifically the inability to coordinate the relaxation of these muscles during bowel movements. This results in difficulty or inability to evacuate stool from the rectum. Symptoms of anismus include incomplete evacuation, the need for prolonged straining, and constipation.
2. Obstructed defecation syndrome (ODS): ODS is a broader term that refers to a group of symptoms related to difficulty with bowel movements, including anismus. However, ODS can also be caused by structural abnormalities or functional disorders of the rectum or anus, such as rectal prolapse, rectocele, or intussusception. Symptoms of ODS can include straining during bowel movements, a sensation of incomplete evacuation, the need for digital manipulation to aid in evacuation, and pelvic pain or discomfort.

In summary, anismus specifically refers to the inability to relax the pelvic floor muscles during bowel movements, leading to difficulty with evacuation. ODS, on the other hand, encompasses a broader range of symptoms related to difficulty with bowel movements and can be caused by a variety of structural or functional issues in the rectum or anus, including anismus. Treatment for both anismus and ODS may involve pelvic floor muscle training, dietary modifications, medications, or surgery, depending on the underlying cause.