Obstructed Defecation Syndrome (ODS)

What is Obstructed Defecation Syndrome (ODS)?

ODS is a condition where normal bowel movements become difficult due to problems with the mechanics of defecation. Despite the urge to pass stool, patients are unable to empty their bowels fully or efficiently.

What causes ODS?

ODS is most commonly caused by structural abnormalities within the pelvis, often related to a weakened pelvic floor or prolapse conditions.

• Internal rectal prolapse (intussusception)
• Rectocoele (bulging of the rectum into the vagina)
• Pelvic floor weakness
• Less commonly, a tight or non-relaxing pelvic floor

Symptoms of ODS

Patients with ODS often experience ongoing difficulty with bowel emptying and may develop coping mechanisms to help pass stool.

• Difficulty passing stool
• Repeated or prolonged visits to the toilet
• Sensation of blockage or incomplete emptying
• Need to use fingers to assist evacuation
• Pressure on the perineum or vaginal wall to pass stool
• Leakage of stool after bowel movements
• Symptoms of faecal incontinence

Diagnosis and tests

After a detailed assessment by a colorectal specialist, a number of investigations may be recommended to identify the underlying cause of ODS.

• Flexible sigmoidoscopy or colonoscopy
• Anorectal physiology testing
• Endoanal ultrasound
• Proctogram (defecating proctography)
• Colonic transit study

Treatment options for ODS

Treatment depends on the underlying cause and severity of symptoms. Many patients improve with non-surgical management, while others may benefit from specialist procedures.

• Dietary changes and stool softeners
• Pelvic floor retraining (biofeedback therapy)
• Laparoscopic ventral rectopexy
• STARR procedure
• Rectocoele repair

Our team will guide you through the most appropriate treatment options based on your individual condition and test results.