Patients are taught to brace the abdominal wall muscles and relax the pelvic floor muscles during defecation, and efforts are also made to modify sensory perception in the rectum .
A questionnaire (Table 1) adapted from the one developed by the Cleveland Clinic was used to assess defecatory symptoms  such as frequency of spontaneous bowel movements, stool consistency, straining during defecation, sensation of incomplete evacuation, sensation of blockage, and painful defecation.
The procedure was performed after defecation. The patient was placed in the left lateral decubitus position, with the hips flexed to 90[degrees].
Key words: dyssynergic defecation; chronic constipation; functional defecation disorders; EMG-biofeedback treatment.
Biofeedback treatment in chronically constipated patients with dyssynergic defecation
During defecation, the puborectalis muscle and the external anal sphincter should relax to permit defecation.
The mean defecation
time was 10 minutes in participants with constipation and 3 minutes in participants without constipation.
(3.) Questions designed to collect information on hygiene-dietary habits that might influence the onset or persistence of constipation; the need to use laxatives or other aids for evacuation (enemas, suppositories, manual procedures, and the hygiene associated with them); whether daily water intake was >1500 ml; following of fiber-rich diets (25-30 g of fiber intake daily); regularity of exercise; mealtimes and defecation times; whether evacuation was ever postponed for social, work, or environmental reasons; rejection of evacuation outside the home; and the suffering from stress or emotional distress that might influence bowel movements.
Compared with males, females showed a significantly more irregular defecation timetable, were more likely to postpone defecation, to be less comfortable while defecating outside the home, and suffered more stress.
Regarding the necessity of any aids for defecation, the use of laxatives was reported by 41 subjects (9.9% of the sample), enemas by 8 (1.9%), suppositories by 22 (5.3%), and manual facilitating maneuvers by 33 (8%).
In this retrospective study the clinical outcome (resolving signs and symptoms of obstructive defecation syndrome) of different modalities, stapled transanal rectal resection, Delorme operation and electrotherapy of hemorrhoids are assessed.
Patient's problems and functional outcome were measured preoperatively and at least once postoperatively during the first year by Wexner score, (16) symptom severity score (table 1) and obstructed defecation syndrome score (table 2).
(2) The validated constipation scoring system (CSS), obstructed defecation syndrome (ODS) score system (table 1) and symptom severity (SS) score (table 2) were used for clinical assessment.
[GRT.sub.min] denotes the time elapsed before the first defecation containing experimental food with markers, and [GRT.sub.max] denotes the time elapsed before the last defecation containing experimental food with markers, after the ingestion of experimental food.
However, the total amount of material processed in the gut during and after the time of ingesting the experimental food affects the available volume in the gut before the next defecation (e.g.