ABSTRACT Backround: Chronic constipation is a common, chronic and frequent problem of the general population. The aim of this study is to assess the efficacy of defecography in diagnosing the etiology of constipation and the relation between constipation and rectocele. Material-method: We have investigated 250 patients who have been admitted to our general surgery out-patient clinic with complaint of constipation using Rome III criteria and diagnostic defecography. Results: Out of 250 patients who were evaluated with defecography only 24 had normal findings. 136 patients were found to have rectocele. Conclusion: We propose that rectocele is an important etiology of constipation, and defecography should be considered early in the diagnosis of rectocele.
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Bozkurt, M. , Sürek, A. , Gönenç, M. , Kalaycı, M. and Alış, H. (2012) Significance of defecography and the role of rectocele in constipated patients. Open Journal of Gastroenterology, 2, 40-44. doi: 10.4236/ojgas.2012.22009.
 Rao, S.S. (2008) Dyssynergic defecationand biofeedback therapy. Gastroenterology Clinics of North America, 37, 569-586. doi:10.1016/j.gtc.2008.06.011
 ?ztürk, R. and Rao, S.S. (2007) Defecation disorders: An important subgroup of functional constipation, its pathophysiology, evaluation and treatment with biofeedback. The Turkish Journal of Gastroenterology, 18, 139-149.
 Wallden, L. (1953) Roentgen examination of the deep rectogenital pouch. Acta Radiologica, 39, 105-116.
 Brodén, B. and Snellman, B. (1968) Procidentia of the rectum studied with cineradiography: A contribution to the discussion of causative mechanism. Diseases of the Colon & Rectum, 11, 330-347. doi:10.1007/BF02616986
 Mahieu, P.H., Pringot, J. and Bodart, P. (1984) Defecography: 1. Description of a new procedure and results in normal patients. Gastrointestinal radiology, 9, 247-251.
 Mahieu, P.H., Pringot, J. and Bodart, P. (1984) Defecography: 2. Contribution to the diagnosis of defecation disorders. Gastrointestinal radiology, 9, 253-261.
 Ganeshan, A., Anderson, E.M., Upponi, S., et al. (2008) Imaging of obstructeddefecation. Clinical Radiology, 63, 18-26. doi:10.1016/j.crad.2007.05.015
 Roos, J.E., Weishaupt, D., Wildermuth, S., et al. (2002) Experience of 4 years with open MR defecography: Pictorial review of anorectal anatomy and diseases. Radiographics, 22, 817-832.
 Mezwa, D.G., Feczko, P.J. and Bosanko, C. (1993) Radiologic evaluation of constipation and anorectal disorders. Radiologic Clinics of North America, 31, 1375- 1393.
 Shorvon, P.J., McHugh, S., Diamant, N.E., et al. (1989) Defecography in normal volunteers: Results and implications. Gut, 30, 1737-1749. doi:10.1136/gut.30.12.1737
 Matikainen, M. (1994) Does defecography help in diagnosis and clinical decision-making in defecation disorders? Abdom Imaging, 19, 355-358.
 Morley, J.E., (2007) Constipation and ?rritable bowel syndrome in the elderly. Clinics in Geriatric Medicine, 23, 823-632. doi:10.1016/j.cger.2007.06.008
 Toglia, M.R. (2009) Pathophysiology of anal incontinence, constipation, and defecatory dysfunction. Obstetrics & Gynecology Clinics of North America, 36, 659- 671. doi:10.1016/j.ogc.2009.08.004
 Pare, P., Ferrazzi, S., Thompson, W.G., et al. (2001) An epidemiological survey of constipationin Canada: Definitions, rates, demographics, and predictors of health care seeking. The American Journal of Gastroenterology, 96, 3130-3137. doi:10.1111/j.1572-0241.2001.05259.x
 Thompson, W.G. and Heaton, K.W. (1980) Functional bowel disorders in apparently healthy people. Gastroenterology, 79, 283-288.
 Donald, I.P., Smith, R.G., Cruikshank, J.G., et al. (1985) A study of constipation in the elderly livingat home. Gerontology, 31, 112-118. doi:10.1159/000212689
 Whitehead, W.E., Drinkwater, D., Cheskin, L.J., et al. (1989) Constipation in the elderly living at home. Definition, prevalence, and relationship to lifestyle and health status. Journal of the American Geriatrics Society, 37, 423-429.
 Campbell, A.J., Busby, W.J., Horwath and C.C. (1993) Factors associated with constipation in a community based sample of people aged 70 years and over. Journal of Epidemiology & Community Health, 47, 23-26.
 Marfil, C., Davies, G.J. and Dettmar, P.W. (2005) Laxative use and its relationship with straining in a London elderly population: free-living versus institutionalised. The Journal of Nutrition Health and Aging, 9, 185-187.
 Wolfsen, C.R., Barker, J.C. and Mitteness, L.S. (1993) Constipation in the daily lives of frail elderly people. Archives of Family Medicine, 2, 853-858.
 Kuijpers, H.C. and Bleijenberg, G. (1985) The spastic pelvic floor syndrome: A cause of constipation. Diseases of the Colon & Rectum, 28, 669-672.
 Read, N.W., Timms, J.M., Barfield, L.J., et al. (1986) Impairment of defecation in young women with severe constipation. Gastroenterology, 90, 53-60.
 Wald, A., Caruana, B.J., Freimanis, M.G., et al. (1990) Contributions of evacuation proctography and anorectal manometry to evaluation of adults with constipation and defecatory difficulty. Digestive Diseases and Sciences, 35, 481-487. doi:10.1007/BF01536923
 Jones, P.N., Lubowski, D.Z., Swash, M., et al. (1987) Is paradoxical contraction of puborectalis muscle of functional importance? Diseases of the Colon & Rectum, 30, 667-70. doi:10.1007/BF02561685
 Arnold, M.W., Steart, W.R. and Aguilar, P.S. (1990) Rectocelerepair: Fouryears’ experience. Diseases of the Colon & Rectum, 33, 684-687. doi:10.1007/BF02150745
 Lembo, A. and Camilleri, M. (2003) Chronic constipation. The New England Journal of Medicine, 349, 1360-1368.
 Shorvon, P.J., McHugh, S., Diamant, N. E., Somers, S. and Stevenson, G. W. (1989) Defecography in normal volunteers: Results and implications. Gut, 30, 1737-1749.
 Karlbom, U., Nilsson, S., Pahlman, L. and Graf, W. (1999) Defecography study of rectal evacuation in constipated patients and control subjects. Radiology, 210, 103-108.
 Siproudhis, L., Ropert, A., Lucas, J., et al. (1992) Defecatory disorders, anorectal and pelvic floor dysfunction: A polygamy? International Journal of Colorectal Disease, 7, 102-107. doi:10.1007/BF00341295
 Turnbull, G.B., Bartram, C.I. and Lennard-Jones, J.E. (1988) Radiologic studies of rectal evacuation in adults with idiopathic constipation. Diseases of the Colon & Rectum, 31, 190-197. doi:10.1007/BF02552545
 Bartolo, D.C., et al. (1988) Symposium: Proctography. International Journal of Colorectal Disease, 3, 67-89.
 Dam, J.H., Ginai, A.Z., Gosselink, M.J., et al. (1997) Role of defecography in predicting clinical outcome of rectocele repair. Diseases of the Colon & Rectum, 40, 201-207. doi:10.1007/BF02054989
 Arnold, M.W., Stewart, W.R.C. and Aguilar, P.S. (1990) Rectocelerepair: Fouryears’ experience. Diseases of the Colon & Rectum, 33, 684-687. doi:10.1007/BF02150745
 Sarles, J.C., Arnaud, A., Selezneff, I., et al. (1989) Endorectal repair of rectocele. International Journal of Colorectal Disease, 4, 167-171. doi:10.1007/BF01649696