Wael Solh and Eric G.Weiss
The causes of constipation and altered defecation are mul-tifactorial, and the manifestations are varied. Etiologies of constipation or altered defecation can be divided into two categories - slow transit constipation, and pelvic outlet obstruction. Pelvic outlet obstruction includes etiologies such as paradoxical or nonrelaxation of the puborectalis muscle or anismus (nonrelaxation of the "anal canal"), rectal prolapse or intussusception, and nonemptying rec-toceles. Associated findings may include perineal descent and solitary rectal ulcer syndrome.
In normal defecation, the pelvic floor muscles and external anal sphincter are voluntarily inhibited resulting in an increase in the anorectal angle with increasing intraabdominal pressure. Patients with nonrelaxing puborectalis syndrome (NRPS) or anismus are unable to voluntarily inhibit contraction of the pelvic floor. When inappropriate function of the puborectalis muscle (inappropriate contraction or failure to relax) results in the inability to evacuate the rectum, the condition is termed anismus. Unlike levator syndrome, anismus is painless.
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Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.