Physiotherapy Approaches in Individuals with Functional Defecation Disorders: Literature Review

Constipation is a gastrointestinal syndrome that causes symptoms such as decreased defecation frequency, straining, hard stools, and abdominal discomfort. It is considered the most common syndrome among gastrointestinal syndromes. Constipation is known to reduce quality of life by causing depression, anxiety, sleep disturbance and sexual dysfunction. It is classified as primary and secondary constipation according to the cause of its occurrence. Secondary constipation occurs due to reasons other than the gastrointestinal system. Primary constipation is basically divided into simple constipation and chronic constipation. Chronic constipation is examined under three subheadings: normal transit time constipation, slow transit time constipation and functional defecation disorders. Functional defecation disorder is characterized by excessive straining, hard stools, a feeling of inadequate evacuation, a feeling of blockage in the anorectal region, the use of manual support, defecation less than 3 times a week, and infrequent defecation without the use of laxatives. It is reported that functional defecation disorders do not respond to standard treatments and that Biofeedback and pelvic floor physiotherapy should be the first step treatment. This review includes a literature review of the physiotherapy methods and their effects, particularly examining functional defecation disorders caused by the pelvic floor muscles and anal sphincters.