A. Patients must satisfy the diagnostic criteria for functional chronic constipation (Rome III) and |
B. Patients must demonstrate dyssynergia during repeated attempts to defecate |
Dyssynergic or obstructive pattern of defecation (types 1-4) is defined as: |
Paradoxical increase in anal sphincter pressure (anal contraction) or |
Less than 20 percent relaxation of the resting anal sphincter pressure or |
Inadequate propulsive forces observed with manometry, imaging, or EMG recordings and |
One or more of the following criteria during repeated attempts to defecate: - Inability to expel an artificial stool (50 mL water-filled balloon) within 1 minute
- A prolonged colonic transit time (ie, greater than five markers [>20 percent marker retention]) on a plain abdominal radiograph taken 120 hours after ingestion of one sitzmark capsule containing 24 radiopaque markers
- Inability to evacuate or ≥50 percent retention of barium during defecography
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