American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the recommended treatment for dyssynergic defecation-related constipation?

1. Biofeedback therapy

2. Laxatives

3. Stool softeners

4. Antidepressants

The correct answer is: Biofeedback therapy

The recommended treatment for dyssynergic defecation-related constipation is biofeedback therapy. This type of therapy is designed to help patients learn how to coordinate their pelvic floor muscles and improve their ability to defecate. In dyssynergic defecation, there is often a coordination problem during the process of bowel movements, which can lead to significant constipation and difficulty passing stool. Biofeedback therapy provides real-time feedback to patients regarding their muscle activity, allowing them to gain awareness and control over the pelvic floor and abdominal muscles. By learning proper muscle coordination during defecation, patients often experience significant improvements in their symptoms and overall bowel function. Other treatments, such as laxatives or stool softeners, may help relieve constipation but do not address the underlying coordination issues associated with dyssynergic defecation. While these options can be beneficial in managing symptoms, they may not lead to a long-term resolution of the condition. Antidepressants may have some effect on gut motility or comorbid anxiety and depression, but they are not specifically tailored to treat the muscle coordination issues central to dyssynergic defecation. Therefore, biofeedback therapy remains the most effective and targeted treatment for this specific type of constipation