Obstructed defecation syndrome (ODS) is a functional pooping disorder. People with ODS have trouble evacuating their bowels, resulting in constipation. It may be for a variety of reasons, both mechanical and psychological. Treatment is usually conservative and holistic, but sometimes surgery is needed.
Obstructed defecation means difficulty pooping. This can be for a variety of reasons, both mechanical and psychological. People with obstructed defecation syndrome (ODS) feel that they can’t poop when they want to, they aren’t pooping often enough or they aren’t pooping everything out all the way. They suffer from constipation, but also sometimes from fecal incontinence, when backed-up poop overflows. They spend a lot of time on the toilet, waiting or straining to poop (defecate). Over time, excessive straining and passage of hard stools can deteriorate the muscles and nerves involved, which adds to the problem.
ODS is a broad umbrella term describing a range of conditions that involve constipation and difficulty defecating. What they have in common are the symptoms of constipation.
Diagnosis of constipation requires two or more of the following symptoms, consistently for 90 days:
These symptoms may only be the tip of the iceberg, however. They often result from underlying conditions that have yet to be discovered.
Having chronic constipation for a long time can also cause its own set of problems. Sometimes, it’s hard to tell what the original cause was and what the effect was.
People with obstructed defecation might also have:
About 18% of the population suffers from the broad range of conditions known as obstructed defecation syndrome. It’s especially common in women and after middle age.
Obstructed defecation feels like:
You may need to:
It may cause:
Common complaints include:
ODS has many causes, both organic and functional. Organic, mechanical causes include things like anatomical defects and physical blockages. Functional causes involve things like the brain and nervous system. Often both kinds are involved, and one kind may have caused another kind.
Any of these may be either primary causes or secondary effects of obstructed defecation.
They may also have been caused by:
Your healthcare provider will begin by asking you about your symptoms. They may use a scoring chart like this to rate how severe your symptoms are:
|Straining to poop||Never||Rarely||Sometimes||Usually||Always|
|Using fingers to poop||Never||Rarely||Sometimes||Usually||Always|
|Use of enemas or laxatives||Never||Rarely||Sometimes||Usually||Always|
|Straining to poop|
|Using fingers to poop|
|Use of enemas or laxatives|
Your score would range from 0 to 20, with 20 points indicating severe symptoms.
A high score indicates chronic constipation, but to diagnose ODS, your healthcare provider will need to rule out simple causes. They’ll do this through evaluation of your medical history and testing.
Once your healthcare provider understands your symptoms, they will recommend tests to learn more. These might include:
Because its causes tend to be complex, with many factors involved, treatment is often conservative and holistic. It’s rarely as simple as corrective surgery. Even when surgery is recommended, and even when it’s successful in correcting an anatomical problem, it doesn't always lead to lasting relief. Symptoms may persist or come back. There are often still other factors to address, perhaps undiscovered yet.
For all people, healthcare providers begin by recommending:
For neurological and psychosomatic symptoms, which affect up to two-thirds of people, they recommend:
For anatomical problems such as organ prolapse, healthcare providers may recommend surgery when other treatments fail. Possible procedures include:
Conservative treatments show improvement in 30% of people. Lifestyle changes and home remedies like laxatives and enemas may be needed indefinitely, but they can offer real relief. Therapies such as biofeedback and psychotherapy require time and commitment to yield results, but they can offer lasting improvements. Surgery has uneven results. It seems to be most successful when combined with other treatments.
A note from Cleveland Clinic
Obstructed defecation is an urgent problem, but understanding what’s causing it can be difficult. You might be surprised to learn how many different body systems are involved in pooping — not to mention the brain. Fortunately, many of the treatments healthcare providers recommend for ODS can apply to anyone suffering from constipation. You can begin implementing lifestyle changes, home remedies and therapy techniques immediately. But it’s still a good idea to see your healthcare provider for testing. They’ll need to rule out or address any contributing diseases or structural problems, and they can talk you through the diagnosis after learning more about your condition.
Last reviewed by a Cleveland Clinic medical professional on 11/30/2021.
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