Dyssynergic Defecation
Understanding how impaired coordination of pelvic floor and abdominal muscles affects bowel movements.
Community experiences, not medical advice
Understanding how impaired coordination of pelvic floor and abdominal muscles affects bowel movements.
Dyssynergic Defecation (also called anismus or pelvic floor dyssynergia) is a functional disorder where the pelvic floor muscles, anal sphincter, and abdominal muscles don't coordinate properly during bowel movements. Instead of relaxing the pelvic floor muscles during a bowel movement, people with this condition may paradoxically contract these muscles, making it difficult to pass stool.
Rome IV names dyssynergic defecation as one subtype of functional defecation disorders: the pelvic floor muscles tighten, or do not relax, when you try to open your bowels, rather than the colon simply being slow. The other subtype is inadequate defecatory propulsion. Biofeedback is the treatment those criteria point to. You can read the Rome IV functional anorectal disorders paper by Rao, Bharucha, Chiarioni and colleagues on PubMed.
NIDDK lists delayed emptying of the colon from pelvic floor disorders as one cause of constipation, especially in women. See NIDDK constipation: symptoms and causes.
Based on experiences shared in our community:
Emptying problems need proper assessment. This is not something you diagnose with a home gadget.
Chiarioni and colleagues randomised people with pelvic floor dyssynergia. At 6 months, 80% (43 of 54) reported major improvement with five biofeedback sessions versus 22% (12 of 55) with polyethylene glycol. Benefits were sustained at 12- and 24-month follow-up.
View on PubMedModi and colleagues (2019) tested a defecation posture modification device in healthy volunteers, not in people with dyssynergic defecation. The study reported less straining and a greater sense of bowel emptiness with the device.
View on PubMedCharity information, including that going three times a day to three times a week can still be a normal range.
Visit Resource Visit Resource Visit ResourceClinical guidelines on the diagnosis and management of dyssynergic defecation, with recommendations for biofeedback therapy (Wald and colleagues, 2021).
Visit Resource View on PubMedReal stories shared by our community members about managing dyssynergic defecation.
"After years of struggling with constipation and incomplete evacuation, I was diagnosed with dyssynergic defecation. Biofeedback therapy was the turning point for me. Learning to coordinate my abdominal and pelvic floor muscles properly took practice, but after 6 sessions, I started noticing significant improvement. I continue to use the breathing techniques I learned and always use a toilet stool for proper positioning."
"My pelvic floor physical therapist taught me specific relaxation exercises that have made a huge difference. I practice deep belly breathing while on the toilet, focusing on relaxing my pelvic floor. I also found that having a consistent morning routine helps—warm water with lemon, a short walk, and then attempting a bowel movement at the same time each day. Consistency and patience have been key."
"I combined several approaches to overcome dyssynergic defecation. Biofeedback therapy gave me the foundation, teaching me how to relax rather than strain. Using visualization techniques helped me—imagining an elevator going down as I tried to have a bowel movement. I also found yoga, particularly poses that relax the pelvic floor, to be incredibly beneficial for maintaining progress over the long term."