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Obstruktive Defäkationsstörungen

Obstructed defecation syndrome

  • Schwerpunkt
  • Published:
Die Gastroenterologie Aims and scope

Zusammenfassung

Hintergrund

Die obstruktive Defäkation ist eine Form der chronischen Konstipation, die eine Entleerungsstörung des Rektums darstellt und mit einer deutlichen funktionellen Einschränkung wie auch einer verminderten Lebensqualität verbunden sein kann.

Ziel der Arbeit

Ziel dieser Arbeit ist die Darstellung der differenzierten Diagnostik, Differenzialdiagnosen und Therapiemöglichkeiten der obstruktiven Defäkation und deren Bewertung vor dem Hintergrund aktueller Studien.

Material und Methoden

Es werden ausgewählte Studien dargestellt.

Ergebnisse

Die obstruktive Defäkation ist eine Erkrankung, die insbesondere in der Abgrenzung zur Beckenbodendyssynergie und der Slow-transit-Konstipation einer sorgfältigen Diagnostik Bedarf. Nach primär konservativer Therapie (medikamentös, krankengymnastisch und irrigierend) stehen bei refraktärem Verlauf und Nachweis eines morphologischen Korrelats der Beschwerden, wie Rektozele und Intussuszeption, sichere operative Verfahren mit gutem funktionellem Ergebnis zur Verfügung.

Diskussion

Für den Therapieerfolg der obstruktiven Defäkation ist die Patientenselektion im Rahmen einer differenzierten Abklärung essenziell.

Abstract

Background

Obstructed defecation is a subcategory of chronic constipation, representing an outlet obstruction of the rectum that can be associated with severe functional impairment and decreased quality of life.

Objectives

The aim is to present the diagnostic assessment, differential diagnoses, and treatment options for obstructed defecation and their evaluation against the background of current studies.

Materials and methods

Selected studies are presented.

Results

Diagnosis of obstructed defecation syndrome requires a meticulous workup in order to rule out pelvic floor dyssynergia or slow transit constipation. After primary conservative treatment with medication, pelvic floor retraining and irrigation, surgical procedures can be considered in case of refractory course and evidence of morphological changes as rectocele or intussusception, with adequate functional results.

Conclusions

Patient selection and an accurate diagnostic evaluation are decisive for successful treatment of obstructed defecation syndrome.

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Authors and Affiliations

  1. Klinik für Allgemein- und Viszeralchirurgie, München Klinik Harlaching, Sanatoriumsplatz 2, 81545, München, Deutschland

    Mia Kim

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  1. Mia Kim
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Correspondence to Mia Kim.

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Interessenkonflikt

M. Kim gibt an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Thorsten Jacobi, Dresden

Michael Fried, Zürich

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Kim, M. Obstruktive Defäkationsstörungen. Gastroenterologie 17, 246–251 (2022). https://doi.org/10.1007/s11377-022-00627-6

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