If you spend hours in the restroom despite a high-fiber diet and the use of laxative syrups, and you cannot evacuate stool as if it is hitting a wall, the underlying cause is highly likely to be anismus. Anismus is a condition where the puborectalis muscle, which surrounds the anus and suspends the rectum, involuntarily and paradoxically contracts further instead of relaxing during defecation. The diagnosis and treatment of anismus are successfully performed in pelvic health clinics in the Adana and Cukurova regions.
Physiology of Anismus
The puborectalis muscle wraps around the anus like a sling, pulling the rectum forward and creating an angle (anorectal angle) that prevents involuntary stool leakage. During defecation, this sling must relax and the angle must straighten. In patients with anismus, this muscle fails to relax; as the patient strains, the muscle tightens even further. This situation is akin to pushing against a closed door. The result is a sensation of incomplete evacuation, manual evacuation maneuvers, and chronic constipation.
Who is Affected?
Anismus is generally observed more frequently in individuals who are perfectionists, highly stressed, received strict toilet training in childhood, or suffer from chronic pelvic pain. It is entirely a muscle coordination disorder and is treatable.