Pelvic outlet obstruction

Orit Kaidar-Person*, Seth A. Rosen, Steven D. Wexner

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


Despite the wide variety of definitions and descriptions of constipation, ideally, the diagnostic approach should be uniform. The evaluation process should begin with a careful and thorough patient history and physical exam; appropriate efforts should be made to exclude organic causes of constipation. Patients suffering from pelvic outlet obstruction often respond poorly to conservative treatment. Diagnostic tests include intestinal transit studies, anorectal manometry, defecography, balloon expulsion, and anal sphincter electromyography. For many patients constipation is multifactorial and accordingly, so is the treatment. In our opinion the first line of treatment should be based on conservative measures including adequate intake of fluids, dietary fiber supplementation, and laxatives. Biofeedback training should be offered, particularly to patients with paradoxical puborectalis contraction. Surgical management can, in very limited circumstances, be offered only to those patients with disabling symptoms who have failed other standard therapeutic measures.

Original languageEnglish
Pages (from-to)337-345
Number of pages9
JournalCurrent Treatment Options in Gastroenterology
Issue number4
StatePublished - Aug 2005
Externally publishedYes


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