Current Gastroenterology Reports

, Volume 13, Issue 4, pp 316–322

Recent Advances in Functional Anorectal Disorders


DOI: 10.1007/s11894-011-0194-8

Cite this article as:
Bharucha, A.E. Curr Gastroenterol Rep (2011) 13: 316. doi:10.1007/s11894-011-0194-8


Defecatory disorders are a common cause of chronic constipation and should be managed by biofeedback-guided pelvic floor retraining. While anorectal tests are necessary to diagnose defecatory disorders, recent studies highlight the utility of a careful digital rectal examination. While obstetric anal injury can cause fecal incontinence (FI), diarrhea is a more important risk factor for FI among women in the community, who typically develop FI after age 40. Initial management of fecal incontinence should focus on bowel disturbances. Pelvic floor retraining with biofeedback therapy is beneficial for patients who do not respond to bowel management. Sacral nerve stimulation should be considered in patients who do not respond to conservative therapy.


Functional anorectal disordersConstipationIrritable Bowel Syndrome (IBS)Defecatory disordersPelvic floor retrainingDigital rectal examinationBalloon expulsion testFecal incontinenceObstetricAnal sphincter injuryPrimiparousAnal incontinenceRectal sensationBiofeedbackRisk factorsCommunityCholecystectomyBariatric surgeryGastric bypassElectrical therapySacral nerve stimulationRadio frequencyBulking-agentNASHA Dx

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Clinical and Enteric Neuroscience Translational and Epidemiological Research Program (C.E.N.T.E.R.), Division of Gastroenterology and HepatologyMayo ClinicRochesterUSA