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Journal of Physical Therapy and Sports Medicine
Volume 1, Issue 1
Euro Physiotherapy 2017
Notes:
Page 59
December 07-08, 2017 Rome, Italy
4
th
Euro-Global Physiotherapy Congress 2017
Rehabilitation of obstructed defecation:
Techniques and treatment outcomes
Filippo Pucciani
University of Florence, Italy
O
bstructed defecation is broadly defined as the inability
to evacuate contents from the rectum, with symptoms
of a subjective sensation of anal blockage during
defecation. It is a subset of constipation, in that it differs
from slow-transit constipation in terms of pathophysiology,
due to outlet pelvic obstruction with anorectal dysmotility.
Outlet obstruction may be caused by organic or functional
diseases: disorders of rectal sensation and pelvic floor
dyssynergia are the main etiologic functional factors.
The treatment of functional diseases is rehabilitative and
multimodal rehabilitation guided by anorectal manometry
is a useful method for managing the pathophysiology
of obstructed defecation. The mean length of the
rehabilitation cycle is about five months. The overall mean
Obstructed Defecation Syndrome score shows significant
improvement after rehabilitative treatment, using two,
three or four rehabilitative techniques (pelviperineal
kinesitherapy, biofeedback, anal electro stimulation, rectal
sensory retraining). Therefore, multimodal rehabilitation of
obstructed defecation provides the opportunity to improve
the severity of symptoms in many patients. Moreover,
multimodal rehabilitation identifies those ‘nonresponders’
who should be next in line for more expensive and
invasive therapeutic procedures (sacral neuromodulation
or surgery).
Biography
Associate Professor of Surgery at University of Florence Department of
Surgery and Translational Medicine.
filippo.pucciani@unifi.itFilippo Pucciani, J Phys Ther Sports Med 2017