Paradoxical Puborectalis Contraction

Along with perineal descent, paradoxical puborectalis contraction is a form of functional constipation that is extremely challenging to diagnose and treat. After a physical examination and a thorough battery of diagnostic tests has been performed by a specialist such as a urogynecologist to rule out the existence of any actual anatomical disorders, patients who have been proven to suffer from paradoxical puborectalis contraction will generally be treated with biofeedback.

Failure of biofeedback to correct the issue may warrant the use of other treatments including:

• Botox injections, which are used to relax the contracted puborectalis muscle.
• Colectomy, which is a resectioning of the colon.
• Colostomy, which brings one end of the colon through an opening created in the abdominal wall to be stitched to the outer abdomen and aid in the evacuation of the intestine.
• End ileostomy, which removes the entire colon through an incision in the abdomen. During the procedure, the end of the small intestine is divided and brought out of the abdomen to be stitched to the skin, thereby forming an opening called a stoma.
• Division of the puboreptalis muscle, which is the muscle that supports the rectum and plays an important role in preventing fecal incontinence.

Signs of Tension

Symptoms of paradoxical puborectalis contraction often include:

• Straining with bowel movements that are prolonged and occur repeatedly
• Feelings of incomplete evacuation of the bowels
• Rectal pain
• Needing digital stimulation of the rectum and sphincter

In cases of paradoxical puborectalis contraction, the relaxed state of the puborectalis and sphincter that would ideally result in a straightened anorectal angle during defecation fails, causing the anorectal angle to be maintained and full evacuation of the bowels to be impossible. This failure of the puborectalis relaxation or paradoxical contraction is linked to an obstruction of the anal outlet.

At Coyle Institute, we have specialists who are experienced in diagnosing and treating paradoxical puborectalis contraction. We take a full medical history and conduct testing to rule out any other conditions, then work with our patients to determine which treatment options are in their best interests.

Relax and enjoy better health! Call the team of experts at Coyle Institute to schedule a consultation today!