Expert Videos

Module 1: Irritable Bowel Syndrome with Constipation (IBS-C)

What is irritable bowel syndrome with constipation (IBS-C) and what causes it?
In this video, Dr. Satish Rao, an expert on irritable bowel syndrome with constipation (IBS-C), describes what this disorder is and what causes it. He explains that irritable bowel syndrome includes abdominal pain or discomfort, gas, and bloating as well as changes in bowel movements. In IBS-C, the change is generally constipation. He describes how sensitive gut-brain interactions appear to play an important role in causing IBS-C and other forms of IBS.
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What are the symptoms of IBS-C?
Dr. Jeanetta Frye, an expert on irritable bowel syndrome with constipation (IBS-C), explains that abdominal pain and discomfort, plus changes in bowel movements, are common symptoms. She describes what may worsen symptoms, when to be concerned, and red flag warning signs that should prompt a visit to the doctor.
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What are the risk factors for IBS-C?
Dr. Satish Rao, an expert on irritable bowel syndrome with constipation (IBS-C), discusses the role of age, gender, lifestyle and global location on the risk for IBS-C. He also notes the possibility that heredity or family history may play a part.
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Is IBS the same as inflammatory bowel disease (IBD)?
Gastroenterologist Dr. Jeanetta Frye explains that irritable bowel syndrome (IBS) is not the same condition as inflammatory bowel disease (IBD), which includes several types of disease such as Crohn's disease and ulcerative colitis (UC). IBD can cause scarring and permanent damage to the bowel, while IBS does not cause long-term damage.
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What if I sometimes have diarrhea with my IBS-C?
Dr. Jeanetta Frye, an expert on irritable bowel syndrome with constipation (IBS-C) and other digestive system diseases, explains that diarrhea may occasionally happen even when constipation is the main problem with bowel movements. This may happen when the "stomach flu", or another condition causes diarrhea. Dr. Frye also reviews the diarrhea-related red flags that should prompt you to call your doctor.
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What if I sometimes have leakage with my IBS-C?
In this video, irritable bowel syndrome (IBS) expert Dr. Satish Rao explains the different ways that bowel leaks can happen even when constipation is the main change in bowel movements, and why it is important to talk with your doctor about bowel leakage.
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How is IBS-C diagnosed?
Dr. Satish Rao, an expert on irritable bowel syndrome with constipation (IBS-C), describes the process of diagnosing this disorder. The symptoms of irritable bowel syndrome (IBS) tend to mimic those of many other diseases. Because of this, Dr. Rao explains the importance of openly sharing information with your physician. Tests to make sure you have IBS are important, and can also help determine what factors are causing constipation.
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Is IBS-C difficult to diagnose, and why?
Expert gastroenterologist Dr. Satish Rao explains that irritable bowel syndrome with constipation (IBS-C), can be difficult to diagnose because there is no specific test for it. Other conditions cause similar symptoms. Seeing a physician who is familiar with IBS and aware of the latest developments and tests can help in making a certain diagnosis.
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Are there certain symptoms that mean I probably have IBS-C?
Dr. Jeanetta Frye, expert on irritable bowel syndrome with constipation (IBS-C), explains that IBS-C is a chronic condition, so you are likely to have symptoms for at least several months. Abdominal pain and discomfort, changes in bowel movements that mostly involve constipation, and symptoms related to stress or other events such as eating may indicate IBS-C. Dr. Frye also explains which signs should prompt you to call your doctor immediately.
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How often should I see my doctor if I have IBS-C? Do I need regular tests?
Gastroenterologist Dr. Jeanetta Frye discusses how often to see your doctor if you have irritable bowel syndrome with constipation (IBS-C). She also talks about the importance of finding the right physician to help you manage your symptoms. Dr. Frye explains that you will probably see your physician regularly for IBS-C, but how often can be different for each person.
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What questions should I ask my doctor about my IBS-C diagnosis?
Dr. Satish Rao, an expert on irritable bowel syndrome with constipation (IBS-C) and other digestive system diseases, reviews some of the most important questions to ask your doctor when you have IBS-C. These include getting a clear diagnosis, managing symptoms, making lifestyle changes and more. These key questions can help you work with your doctor to manage IBS-C and be more comfortable.
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What are the various treatment options for IBS-C?
In this video, gastroenterologist Dr. Jeanetta Frye explains that several treatment options are available for irritable bowel syndrome with constipation (IBS-C). These include lifestyle changes such as changes in diet and fiber intake as well as developing coping strategies for life events. Dr. Frye also notes that there are several medication options available for IBS-C.
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What can I do at home to manage my IBS-C?
Expert gastroenterologist Dr. Satish Rao explains the many options for managing your irritable bowel syndrome with constipation (IBS-C) at home. These include finding the right stool softener, managing pain, gas and bloating with a form of peppermint oil or traditional antispasmodic medications, and making lifestyle changes. They may also include identifying events that trigger your IBS-C and developing routines to manage anxiety, stress, and sleep problems.
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Is there a specific diet for IBS-C?
In this video, Dr. Jeanetta Frye, an expert on irritable bowel syndrome with constipation (IBS-C), discusses the role of food and diet in IBS-C. She addresses the popular idea of food-elimination diets, including the low-FODMAP diet. Dr. Frye recommends working with your doctor and a dietitian experienced with irritable bowel syndrome to avoid causing further problems or eliminating needed nutrition. She also notes that breath tests are available to check for intolerance to specific substances, including lactose, fructose, sorbitol, and the fructans found in wheat.
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What prescription medicines are available for IBS-C?
Dr. Satish Rao discusses the different prescription medications available in the United States to treat irritable bowel syndrome with constipation (IBS-C) and how they work inside the bowel. The medications discussed are lubiprostone, which helps with constipation but does not relieve pain, as well as linaclotide and plecanatide. These two medications are designed to relieve pain as well as constipation in IBS-C.
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If prescription medications are not helping my IBS-C, what other medical therapies can I try?
Dr. Jeanetta Frye, an expert on irritable bowel syndrome with constipation (IBS-C), describes the use of antidepressant and antispasmodic medicines. She and colleague Dr. Satish Rao also note that the serotonin agonist, tegaserod, has been recently reintroduced. A new medication, tenapanor, may be another option for treating IBS with constipation. Talking to a gastroenterologist who is aware of the latest treatments is an important step in managing IBS-C.
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Can probiotics help my IBS-C? How should I take them?
In this video, expert gastroenterologist Dr. Satish Rao discusses the current probiotic craze, the safety of probiotic supplements, and how probiotics actually work. He also describes the role of the microbiome in IBS-C, the potential effectiveness of over-the-counter probiotics, and how these digestive supplements can actually cause gas and bloating in irritable bowel syndrome with constipation (IBS-C). Dr. Rao also discusses the role of fermented foods, including yogurt, kombucha, and more.
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Are there clinical trials for IBS-C? Can I participate in new research?
Dr. Satish Rao, an expert and leading researcher on irritable bowel syndrome with constipation (IBS-C), describes where to find clinical trials for this condition, including through the International Foundation for Gastrointestinal Disorders, or IFFGD. He describes advances including gut-targeted drugs to treat IBS-C more precisely. Dr. Rao also explains the need for volunteers to participate in clinical trials in IBS-C research in order to expand knowledge and find new treatments.
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What questions should I ask my doctor about IBS-C treatment?
In this video, irritable bowel syndrome expert Dr. Jeanetta Frye explains the importance of learning about your irritable bowel syndrome with constipation (IBS-C), preparing for your appointments, and sharing any concerns about the cost of medication. She also discusses what to do if treatment is not helping, including asking about a specialized motility center for further IBS-C testing and diagnosis.
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Module 2: Chronic Constipation (CC)

What is chronic constipation and what causes it?
Expert gastroenterologist Dr. Satish Rao describes the long-term bowel problem of chronic constipation and the possible causes. He explains the difference between chronic and occasional constipation, how many bowel movements a week is considered constipation, and what can cause occasional constipation. He also describes primary and secondary chronic constipation and what medications and conditions can cause secondary constipation. Dr. Rao also discusses opioid-induced constipation and when the medical term "chronic idiopathic constipation" is appropriate.
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What are the symptoms of chronic constipation?
Expert gastroenterologist Dr. Satish Rao shares the most current medical thinking about chronic constipation symptoms, including the six most common symptoms. He explains how many of these you are likely to have if your doctor diagnoses chronic constipation. Dr. Rao also reviews when constipation can be a sign of a serious condition, including sudden constipation and bleeding. He suggests questions to ask yourself and your doctor about possible constipation causes, including any new medications.
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What are the risk factors for chronic constipation?
Dr. Jeanetta Frye, expert on chronic constipation, discusses the various risk factors for this condition. She explains how gender and chronic constipation can be related, as well as the role of surgery in causing chronic constipation. Finally, Dr. Frye describes medical treatments and conditions that can cause chronic constipation.
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How is chronic constipation different from occasional constipation?
Gastroenterologist Dr. Jeanetta Frye explains the difference between chronic constipation and occasional constipation (also called intermittent constipation). The main factor is how long-lasting the constipation is and when it occurs. Constipation due to travel or changes in diet is usually occasional.
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Should I keep track of my chronic constipation symptoms?
Dr. Satish Rao, an expert on chronic constipation, explains that many people have difficulty remembering their chronic constipation symptoms accurately. Keeping track of your symptoms can include writing down the time of bowel movements, any medications you use, what you eat and drink, and more. Dr. Rao notes that apps are now available to keep track of symptoms. Writing symptoms down in a diary or using a constipation app gives your doctor better information than trying to remember on your own.
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Could chronic constipation be a sign of another condition?
Dr. Satish Rao, an expert on chronic constipation, explains which medical conditions your doctor should test for if you have long-lasting constipation. These conditions include Parkinson's disease, diabetes and others. Treating the condition may relieve constipation.
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How is chronic constipation diagnosed?
Medical expert Dr. Satish Rao describes how chronic constipation is diagnosed, including the use of medical history and tests that can identify a condition causing it. He explains when a colonoscopy is needed and what other tests you may have, including a colon transit study and a motility capsule. Dr. Rao also describes how anorectal manometry and the balloon expulsion test can help doctors find the source of constipation.
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Do I need a physical exam for chronic constipation?
In this video, Dr. Satish Rao, an expert on chronic constipation, describes the importance of taking a complete medical history and doing an appropriate abdominal and rectal exam to identify chronic constipation. He discusses common concerns about these exams, how they are generally painless, and important ways to learn more about the cause of constipation.
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Are there certain symptoms that mean I have chronic constipation?
Expert on chronic constipation Dr. Jeanetta Frye reviews the specific symptoms that may mean you have chronic constipation. These include having constipation for a certain length of time, having a certain number of bowel movements each week, and what your bowel movements look and feel like. Dr. Frye also discusses how you may feel after a bowel movement and what you need to do to have one if you have chronic constipation.
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Do certain symptoms mean I could have a serious condition?
Dr. Jeanetta Frye, an expert on chronic constipation, discusses the "red flags" that mean you should talk to your doctor immediately, including bleeding, losing weight, and sudden changes in your bowel movements. Learn about the symptoms that could mean a serious condition is causing your constipation.
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How often should I see my doctor for chronic constipation? Do I need regular tests?
In this video, Dr. Satish Rao, an expert on chronic constipation, discusses how often you should see your doctor at first for your chronic constipation and how long it may take to stabilize this condition. He also talks about whether you need further testing after diagnosis, when you may need repeat testing, and what to do if the treatment stops working.
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What questions should I ask my doctor about my chronic constipation diagnosis?
Expert gastroenterologist Dr. Jeanetta Frye details how you can be an informed patient regarding your chronic constipation. This includes asking your doctor how they know you have chronic constipation, tracking your constipation symptoms, and learning about diet and lifestyle changes.
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What are the various treatment options for chronic constipation?
Gastroenterologist Dr. Satish Rao discusses the current treatment options for chronic constipation, including lifestyle changes, medications, and biofeedback. Treatment for people with diabetes or another condition causing constipation may require seeing additional specialists. Learn if your primary care doctor can help you manage your chronic constipation and if stress and anxiety might play a role.
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Is there a specific diet to help with chronic constipation?
Gastroenterologist Dr. Jeanetta Frye explains the importance of fiber and hydration for chronic constipation, as well as tracking your symptoms to manage any bloating from increased fiber. Prunes and other high-fiber foods such as whole grains may be helpful, but Dr. Frye suggests finding and working with a dietitian specializing in bowel disorders and chronic constipation, as personalized recommendations can help the most.
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What can I do at home to manage my chronic constipation?
Gastroenterology expert Dr. Jeanetta Frye talks about the importance of "listening to your colon" when you have chronic constipation. She discusses helpful bowel habits, how often to exercise, and the role of diet and hydration in managing chronic constipation at home.
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What are the main treatments for chronic constipation and chronic idiopathic constipation?
Gastroenterology expert Dr. Satish Rao discusses the main treatments for chronic constipation, including over-the-counter medications. These include stimulant laxatives and stool softeners. He also talks about polyethylene glycol for constipation, and specific FDA-approved medications including lubiprostone, linaclotide, plecanatide, and prucalopride. These drugs are approved for a condition called "chronic idiopathic constipation," and Dr. Rao discusses the meaning of this term.
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Are there clinical trials for chronic constipation? Can I participate in new research?
Gastroenterology expert Dr. Satish Rao describes several new clinical trials for chronic constipation, including the use of a vibrating capsule and a new drug approved in Japan, elobixibat. Other trials include further studies of biofeedback, which already helps some forms of chronic constipation. Dr. Rao recommends the International Foundation for Gastrointestinal Disorders (IFFGD) clinical trials database to find trials. Learn about other sources to find clinical trials and the importance of research volunteers in developing chronic constipation treatments.
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What questions should I ask my doctor about chronic constipation treatment?
In this video, Dr. Jeanetta Frye, an expert on chronic constipation, describes how to prepare questions for your doctor. She also discusses tracking your symptoms and bowel movements, discussing your best treatment options, and asking about side effects, cost of medications, and finding constipation treatment near you.
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Module 3: Opioid-Induced Constipation (OIC)

What is opioid-induced constipation (OIC)?

In this video, expert gastroenterologist Dr. Jeanetta Frye explains what opioid medications are and how opioid-induced constipation, or OIC, is part of a syndrome caused by these medications that are often prescribed for pain.

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How do opioid medicines cause constipation?

Dr. Satish Rao, an expert on constipation and the digestive system, explains the various ways that opioid medicines affect the nerves and muscles of the gut. Their action can cause constipation and other health problems. He also describes how recent research shows these medicines can actually be a source of pain and inflammation instead of relieving it.

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What are the symptoms of opioid-induced constipation (OIC)?

Dr. Jeanetta Frye explains the symptoms of opioid-induced constipation, including decreased frequency of bowel movements, straining, hard bowel movements and bloating. She describes when this condition is likely to start and get worse. Dr. Frye also mentions warning signs of a serious condition, including bleeding and sudden symptoms, and what to ask your doctor if you are over 50.

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What are the main reasons for treatment with opioids?

Gastroenterologist Dr. Satish Rao explains that while opioids can cause many side effects, including constipation, they are very effective for relieving certain types of pain. Opioids can relieve pain that is not managed with over-the-counter medications such as acetaminophen (paracetamol) and other readily available medications. A condition such as severe back pain, a fall or other injury, or even a heart attack are all examples of conditions for which doctors might prescribe opioids to relieve pain.

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What questions should I ask my doctor about opioid-induced constipation (OIC)?

Dr. Jeanetta Frye, an expert on the bowel and digestive system, explains that it is important to know if opioids are right for you and if you are taking the correct opioid dose. It is important to communicate honestly with your doctors about all your symptoms, including your pain level and constipation. Having all your doctors share information can be a key to managing both pain and opioid-induced constipation.

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How is opioid-induced constipation (OIC) diagnosed?

Opioid-induced constipation (OIC) is the most likely diagnosis if your constipation symptoms began around the same time you started taking opioid medications. Gastroenterologist Dr. Jeanetta Frye describes what questions your doctor is likely to ask about your constipation, including your daily routine, exercise, intake of water and other fluids, and diet. She explains how a rectal exam can be important to look for other possible causes of constipation.

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Is opioid-induced constipation (OIC) difficult to diagnose?

Gastroenterologist Dr. Satish Rao describes the process of diagnosing opioid-induced constipation. A thorough diagnosis includes comparing the dates when constipation started and when the patient began taking opioids, and more. Dr. Rao explains additional tests to find the cause of constipation, what an abdominal X-ray can tell your doctor, and how opioid medications may be just one factor in bowel problems.

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What questions should I ask my doctor about diagnosing opioid-induced constipation (OIC)?

Dr. Jeanetta Frye, an expert on chronic constipation, says communication with your doctor is key in diagnosing opioid-induced constipation, or OIC. The best situation is to have a pain specialist (or other healthcare provider who can prescribe opioid medicines), work with the gastroenterologist and patient to find the lowest dose of opioids that will control pain. Talking openly and honestly with your doctor about all your symptoms is very important to diagnosing and managing OIC.

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What are the various treatment options for opioid-induced constipation (OIC)?

Gastroenterologist Dr. Jeanetta Frye describes lifestyle changes that can help treat opioid-induced constipation (OIC). These can include exercise, fiber, and hydration. Dr. Frye describes the medications available without a prescription and when it is time to talk with your doctor about prescription medications and other possible treatments for OIC.

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Can I manage opioid-induced constipation (OIC) at home, or should I see a doctor?

In this video, expert gastroenterologist Dr. Satish Rao describes ways to manage your opioid-induced constipation (OIC) on your own. These include learning the best timing for your opioid medications and how to adjust and space out doses. He also discusses long-term approaches to pain management, including yoga and progressive muscle relaxation, and the importance of giving these approaches time to work. Finally, Dr. Rao discusses the role of diet, exercise, and lifestyle changes in reducing OIC and pain.

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What are the main prescription medicines for opioid-induced constipation (OIC)?

Gastroenterologist Dr. Jeanetta Frye, an expert on chronic constipation, discusses the main prescription medications available to treat opioid-induced constipation (OIC).  These medications include lubiprostone, methylnaltrexone bromide, naloxegol and naldemidine. Dr. Frye explains how each one works to help relieve OIC, such as by blocking the effects of opioid medications in the digestive system.

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Do I have to live with opioid-induced constipation (OIC)?

Dr. Satish Rao, an expert on constipation, explains the options for reducing or living without opioid-induced constipation (OIC) and how talking with your doctor in detail can help you explore options that may help. These include changing your dosage, using non-opioid medications to control pain, and trying prescription medications to block the effects of opioids on the digestive system (opioid antagonists).

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Can I stop taking opioids for pain? Are there alternatives?

In this video, expert gastroenterologist Dr. Jeanetta Frye discusses the importance of knowing why you are taking opioid medications and taking the lowest possible dose. She explains that other options are available to treat chronic pain, such as changing your pain medicine and taking a non-opioid medication. Talking with the doctor who prescribes your opioid medication is a key step in managing and reducing opioid-induced constipation (OIC).

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Are there clinical trials for OIC? Can I participate in new research?

Dr. Satish Rao, a noted gastroenterologist, explains the importance of participating in clinical trials. This is the main way researchers discover new treatments for all conditions, including opioid-induced constipation (OIC). He recommends the International Foundation for Gastrointestinal Disorders (IFFGD) clinical trials database and other sources to find clinical trials for constipation and OIC.

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What questions should I ask my doctor about opioid-induced constipation (OIC) treatment?

Gastroenterologist Dr. Jeanetta Frye suggests questions to ask your doctor about treating opioid-induced constipation (OIC). These include why you are taking opioid medications, what side effects may happen with various medications, and what other treatment options may help you control pain and avoid constipation.

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Module 4: Dyssynergic Defecation (DD)

What is dyssynergic defecation, and what causes it?

Dr. Satish Rao, an expert on constipation, describes dyssynergic defecation, including how common it is in people with chronic constipation. He discusses what his own and others' research tells us about the causes of this disorder, including surgery, injury, and abuse. A few people have dyssynergic defecation with no known cause. 

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What are the symptoms of dyssynergic defecation?

Gastroenterologist Dr. Satish Rao discusses what to tell your doctor about your constipation symptoms. Learn about the main symptom that tells your doctor you may have dyssynergic defecation, why you may still be constipated if you have frequent bowel movements, and the telltale sign of dyssynergic defecation related to laxatives and other constipation medications.

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What are the risk factors for dyssynergic defecation?

Digestive system expert Dr. Jeanetta Frye describes how muscle tension and lack of muscle coordination can play a role in the development of dyssynergic defecation. Back surgery, pelvic floor surgery, and childbirth can also put people at risk. Physical problems, including rectal problems, can be another factor in developing this type of chronic constipation.

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How is dyssynergic defecation diagnosed?

Gastroenterologist and constipation expert Dr. Satish Rao describes specific ways doctors can diagnose dyssynergic defecation, such as digital rectal examination and anorectal manometry. He also describes how the balloon expulsion test is done, and the value of defecography and colon transit studies in making a definite diagnosis of this condition.

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How is dyssynergic defecation managed and treated?

Dr. Satish Rao, an expert on constipation and dyssynergic defecation, discusses the role of biofeedback in training people to develop healthy bowel movement patterns. This technique makes muscle effort visible in order to teach improved coordination, potentially including posture and breathing. Dr. Rao describes how effective this type of physical therapy can be in resolving dyssynergic defecation. The use of home biofeedback devices can help if a therapist or specialty treatment center is not available nearby.

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This educational activity has been developed by the International Foundation for Gastrointestinal Disorders and Mechanisms in Medicine Inc.

This activity is supported by independent educational grants from Allergan, Ironwood Pharmaceuticals and Takeda.

This website is part of the Animated Patient™ series developed by Mechanisms in Medicine Inc., to provide highly visual formats of learning for patients to improve their understanding, make informed decisions, and partner with their healthcare professionals for optimal outcomes.