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Supporting patients with defecatory dysfunction

Tuesday 23 March 2021

“Functional anorectal disorders” comprise all conditions relating to disordered defecation – including faecal leakage, faecal incontinence, and obstructed defecation (difficulty in satisfactorily emptying the rectum). These patients often experience chronic abdominal pain, bloating, pelvic pain, nausea, straining at stool or multiple visits to the toilet. The disorders are very common (one study showed about 30% of people presenting to their GP had symptoms of a functional anorectal disorder), and there is a large crossover with irritable bowel syndrome.

The disorders can impact people of all ages and lifestyles, but 80% are female; mainly women who have had a vaginal delivery, with the symptoms often taking decades to present. There are other causes, however, including people who have had pelvic surgery, those who develop a poor defecatory technique, lift heavy weights or engage in strenuous sport. Others have had severe psychological stress or even experienced sexual abuse.

Some patients avoid eating so they won’t have to open their bowel, some become unable to work, with the problem affecting their relationships and functioning in society. There are significant impacts on mental health leading to depression and anxiety – with many patients feeling the problem is “in their head”.

At Brisbane Colorectal, Dr Chris Gillespie, Dr. Tim Slack and their team at Mater Private Hospital Brisbane have set up a service dedicated to helping patients with these issues receive treatment in a safe and respectful environment. Many patients start by feeling a sense of relief with an explanation and validation of their symptoms alone.  

Dr. Gillespie and Dr. Slack have a multidisciplinary team comprising specialist pelvic floor physiotherapists, dietitians, gastroenterologists and stomal therapists and with combined care, patients can achieve a better quality of life. Treatment is aimed initially at conservative therapy, targeted at low-risk interventions which can improve symptoms, including “biofeedback therapy”, retrograde rectal irrigation, anal plugs, laxative and fibre supplement along with dietary alternations. Dedicated anorectal physiology tests are available at Brisbane Colorectal, and for some patients more invasive treatments are available such as sacral nerve stimulation, rectopexy surgery, sphincter repair and local perineal procedures. For a small percentage of patients, irrigation via appendicostomy or stoma formation are also options.

To find out more about the clinic please call 07 3010 3360 or visit the website here.

For patients that fit the criteria, referrals can be made to Dr Chris Gillespie or Dr Tim Slack at:

Brisbane Colorectal
Suite 1, Level 3 Mater Private Clinic
550 Stanley St
South Brisbane QLD 4101

Phone: 07 3010 3360
Fax: 07 3844 3635

 

 

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