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Positive features of dissociative or non-epileptic seizures include prolonged motionless unresponsiveness, long duration episodes (>2minutes) and symptoms of dissociation prior to the attack. These signs can be usefully discussed with patients when the diagnosis is being made.
The faeces being in the colon for a longer time will mean that more water is absorbed leading to harder stools and therefore increasing the symptoms of constipation. This neurological problem can also lead to reduced sensation of rectal filling and weakness of the anal sphincter because of weak muscular contraction so can cause stool leakage. [12]
Functional constipation, also known as chronic idiopathic constipation (CIC), is defined by less than three bowel movements per week, hard stools, severe straining, the sensation of anorectal blockage, the feeling of incomplete evacuation, and the need for manual maneuvers during feces, without organic abnormalities.
Obstructed defecation is one of the causes of chronic constipation. [22] ODS is a loose term, [20] consisting of a constellation of possible symptoms, [7] caused by multiple, complex [23] and poorly understood [24] disorders which may include both functional and organic disorders. [18]
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Where anismus causes constipation, it is an example of functional constipation. Many authors describe an "obstructed defecation syndrome", of which anismus is a cause. [24] The Rome II classification functional defecation disorders were divided into 3 types, [25] however the symptoms the patient experiences are identical. [26]
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