Defecation Dyssynergia is most commonly due to the inability of the pelvic floor or anal sphincter muscles to relax during defecation. Often times a paradoxical contraction may occur when attempting to relax the pelvic floor muscles further inhibiting bowel function and emptying. A paradoxical contraction is when the pelvic floor muscles contract when they are supposed to relax. When this is the case, Biofeedback and Manual therapy is the most appropriate treatment, in addition to having proper diet and behavior/habits for bowel health. However, in this situation diet is not the cause and specific physical therapy interventions are required in order to retrain the pelvic floor muscles. See Constipation and Bowel Retraining for more information on treatment.
Always start with diet and lifestyle modifications as poor nutrition and habits may contribute to the cycle of defecation disorders. For example, having hard stools (Type 1, 2, or 3 on the Bristol Stool Chart) will negatively effect the ability to evacuate and cause straining which will increase tone and poor coordination of the pelvic floor muscles contributing to paradoxical contractions.