Dyschezia

Overview

What is dyschezia?

Dyschezia literally means difficulty pooping. Another name for dyschezia is disordered defecation. Healthcare providers use the term “dyschezia” differently when talking about infants or adults, which can be confusing.

  • Dyschezia in adults is more of a description than a condition. It means that you can’t poop without having some type of difficulty, straining or pain. This could be for a lot of reasons. Constipation often relates to dyschezia in adults, either as the cause of your difficulties or as a side effect.
  • Infant dyschezia is a specific condition. Another name for infant dyschezia is grunting baby syndrome. Infants with dyschezia appear to have difficulty pooping, but they have no signs of constipation. They might strain, grunt or cry for 10 to 30 minutes before they poop, but when the poop comes out, it's normal.

Infant dyschezia is a muscle coordination problem. It means that your baby is having trouble coordinating the different muscle groups necessary to poop. This is a learned reflex, and some babies struggle a bit more than others to learn it. They usually figure it out within a week or two.

It’s upsetting for parents to watch their babies struggle, but infants with dyschezia aren’t sick or suffering. Pediatricians believe these infants cry to produce the necessary abdominal pressure to poop, not because they’re in pain. No treatment is necessary or recommended.

Symptoms and Causes

What symptoms are associated with adult dyschezia?

Your healthcare provider might use the term “dyschezia” to describe your condition if you experience:

What symptoms are associated with infant dyschezia?

Infants with dyschezia may show symptoms such as:

  • Struggling to poop for at least 10 minutes.
  • Grunting, crying or screaming while they try to poop.
  • Turning red in the face with effort.
  • Squirming or kicking their feet.
  • Not succeeding in pooping every time.
  • Poop that looks “normal” — soft or pasty — when it comes out.

How can I tell if my baby has dyschezia vs. constipation?

Parents of babies with infant dyschezia often mistake it for constipation at first. They see their baby straining to poop, and they assume that’s because the poop is too hard to pass. This is, after all, usually the reason why adults strain to poop. Adults don’t remember that they once had to learn how to do it.

Straining to poop looks the same, whether they’re straining against hard poop or against their own muscles. But you can tell which kind of struggle it is from the poop that comes out. If the poop is hard or bloody, that’s a sign of constipation. If the poop looks normal, the poop itself isn’t the problem.

How can I tell if my baby has infant dyschezia vs. colic?

Colic is another condition that causes babies to cry inconsolably for no discernible reason. Babies with colic often appear to be in gastrointestinal distress. They might arch their backs, clench their fists or pull their legs up to their tummies while crying, and sometimes they turn red in the face.

Parents and doctors alike once assumed digestive system issues such as gas, reflux, indigestion or difficulty pooping might relate to colic. But evidence of this is scarce, and parents have observed that colic episodes don’t necessarily correspond with feeding cycles.

Colic is still a mystery, but some now believe that it may be, like infant dyschezia, a developmental phase — one that you just have to wait out. This doesn’t stop either colic or infant dyschezia from causing parents a lot of distress. We want to know what’s going on and how to fix it.

In general, doctors diagnose colic when they can’t find any other explanation for your baby’s fussiness. Infant dyschezia is one possibility they might try to exclude first. If you notice that your baby is fussy before pooping in particular, and that it ends when they poop, they might have infant dyschezia.

What causes dyschezia in adults?

Several conditions can cause dyschezia in adults, including:

  • Anismus: This condition can cause adults to struggle with their pooping muscles, similar to the way babies with infant dyschezia do. Another name for anismus is dyssynergic defecation.
  • Endometriosis: People with endometriosis may have difficulty, pain or rectal bleeding during pooping if their endometriosis spreads to their lower bowel, near their rectum.
  • Constipation: Hard, impacted poop can be difficult and painful to pass. Prolonged constipation can also damage the muscles and nerves that control pooping, causing further problems.
  • Inflammatory bowel disease: Chronic conditions such as ulcerative colitis and Crohn’s disease can cause chronic inflammation and bleeding in your lower large bowel (your rectum and anus).
  • Anorectal lesions: Temporary wounds or growths can cause pain or obstruction while pooping, including hemorrhoids, anal fissures, anal abscesses, colon polyps and tumors.

What causes infant dyschezia?

Infants and children are constantly developing, and they take their time with different skills. Pooping, believe it or not, is one of those skills. It takes a lot of coordination between the brain, nerves and different muscle groups to synchronize the act of pooping, especially without gravity on their side.

Normally, poop entering your rectum triggers your anus muscles to release and let it through. Since infants can’t sit up yet, the pressure in their rectum might be weaker, and it may take more abdominal pressure to push it through. They also have to figure out how to push and release at the same time.

Infants who are trying to push poop out against a clenched anus will struggle and possibly cry with frustration until they learn to relax it. Infants may also cry because they sense that crying helps them contract their abdominal muscles. It may be part of their process of figuring out how to push poop out.

Diagnosis and Tests

How is dyschezia diagnosed in adults?

Dyschezia in adults is a symptom, and your symptoms are what you say they are. If you tell a healthcare provider that you have difficulty pooping, they’ll write it down and ask you more about it. It may relate to a condition you already know that you have, or it may lead you to discover an underlying condition.

How is infant dyschezia diagnosed?

Your pediatrician will ask you about your baby’s symptoms and what their poop is like. They may ask for a poop sample. They’ll also give your baby a basic physical exam. If their anatomy looks normal, their poop looks normal and their symptoms only involve the act of pooping, they’ll diagnose infant dyschezia.

Management and Treatment

How do you relieve dyschezia in adults?

Dyschezia in adults can mean different things, and it can have many different causes. Your healthcare provider will need to isolate the cause in order to recommend the right treatment. Possible treatments for pooping difficulties include medications, physical therapy, biofeedback and sometimes surgery.

How can I help my baby with dyschezia?

There’s no treatment for infant dyschezia, and pediatricians don’t advise interfering. This is hard to hear for parents who want to relieve their babies’ struggles. It may be tempting to try to help by stimulating their rectum. But this delays their own learning process and may make them dependent on stimulation.

There’s some research to suggest that infant massage can help stimulate your baby’s nervous system and their physical development. While not a direct treatment for dyschezia, regular massage may improve the brain-body coordination they need to develop in order to learn how to poop.

Outlook / Prognosis

What is the outlook for adults with dyschezia?

Some pooping problems are relatively easy to treat, and others can be more elusive, especially when they involve your brain and nervous system. In these cases, healthcare providers often take a holistic approach that combines diet and lifestyle changes with various therapies. This approach takes time.

If you have a chronic disease or a physical lesion that causes pain and difficulty pooping, surgery might have a place in your treatment plan. Surgery is usually the last resort for people with severe symptoms that don’t respond to other treatments or complementary medicine. But it’s often successful.

When do babies grow out of infant dyschezia?

The good news is that infant dyschezia is usually a brief problem, lasting a few days to weeks. Even this can feel like forever when you witness your baby’s daily struggles. But you can rest assured that they’ll overcome it. Most have outgrown dyschezia by the time they’re two to three months old.

A note from Cleveland Clinic

Pooping difficulties will make you miserable, whether you’re an infant, child or adult. Fortunately, infant dyschezia is short-lived and resolves on its own. Adult dyschezia can be more complicated and can take longer to resolve. If you have dyschezia, don’t delay seeing a qualified healthcare provider about it.

Last reviewed by a Cleveland Clinic medical professional on 08/25/2022.

References

  • International Foundation for Gastrointestinal Disorders. Infant Dyschezia. (https://aboutkidsgi.org/lower-gi/childhood-defecation-disorders/infant-dyschezia/) Accessed 8/25/2022.
  • MSD Manual Consumer Version. Constipation in adults. (https://www.msdmanuals.com/en-gb/home/digestive-disorders/symptoms-of-digestive-disorders/constipation-in-adults) Accessed 8/25/2022.
  • Zeevenhooven J, Koppen IJ, Benninga MA. The New Rome IV Criteria for Functional Gastrointestinal Disorders in Infants and Toddlers. (https://pghn.org/DOIx.php?id=10.5223/pghn.2017.20.1.1) Pediatr Gastroenterol Hepatol Nutr. 2017 Mar;20(1):1-13. Accessed 8/25/2022.

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