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dyssynergic defecation

Etiology: - sexual abuse - obstetric trauma (childbirth) - pelvic surgery - pelvic trauma Physical examination: - inability to relax puborectalis & external anal sphincter during digital rectal examination (positive predictive value is 97%) [1] Pathology: - inability to coordinate relaxation of the puborectalis & external anal sphincter while increasing intra-abdominal pressure that results in normal defectation Management: - biofeedback - commonly provided by physical therapist with specialized training [1]

General

posttraumatic stress disorder (PTSD); includes acute stress disorder

References

  1. Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015