Psychiatric Disorder in Anorectal Dyssynergia

Study Overview
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Brief Summary
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evaluate psychiatric disorders among patients with anorectal dyssynergia evaluate the effect of delayed diagnosis of anorectal dyssynergia on the quality of the life

Detailed Description
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Functional constipation is a functional bowel disorder that presents as persistently difficult, infrequent, or seemingly incomplete defecation. Subjective and objective definitions of constipation include: (1) straining, hard stools (hard, inspissated stool), unproductive calls (want to but cannot), infrequent stools, or incomplete evacuation. (2) <3 bowel movements per week, daily stool weight <35 g/day, or straining >25% of the time Dyssynergia defecation is common and affects up to one half of patients with chronic constipation. This acquired behavioral problem is due to the inability to coordinate the abdominal and pelvic floor muscles to evacuate stool The etiology of dyssynergic defecation is unclear however it was found that the problem began during childhood in 31% of patients, and after a particular event, such as pregnancy, trauma, or back injury in 29% of patients, and there was no cause in 40% of patients. The first step in making a diagnosis of dyssynergic defecation is to exclude an underlying metabolic or pathologic disorder .A detailed history, prospective stool diaries, and a careful digital rectal examination will not only identify the nature of bowel dysfunction, but also raise the index of suspicion for this evacuation disorder. Anorectal physiology tests and balloon expulsion test are essential for a diagnosis. Newer techniques such as high-resolution manometry and magnetic resonance defecography can provide mechanistic insights. . anorectal dyssynergia impact quality of life and cause psychiatric problems such as of anxiety, depression, obsessive compulsiveness, psychoticism, and somatization. So, the investigators aim to evaluate psychiatric disorders among those patients and impact of delayed diagnosis on their quality of life.

Official Title
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Psychiatric Assessment of Patients With Anorectal Dyssynergia and the Impact on the Quality of Life

Conditions
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Anorectal Disorder, Psychiatric Disorder

Intervention / Treatment
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* Other: questionaire


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients diagnosed as anorectal dyssynergia with anorectal manometric study Exclusion Criteria: patient with diabetes mellitus ,hypertension ,chronic kidney disease ,and chronic liver disease patients patient with neurological disease patient with thyroid disease patient with past history of psychiatric disorders patients with past or current medications or substance induced psychiatric disorders

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: questionaire|Psychiatric interview: this will be assessed by (SCID-5)semi structural clinical interview based on Diagnostic and Statistical manual of Mental disorders-5 criteria -Psychometric assessment include; Hamilton depression rating scale(7) and Hamilton anxiety rating scale(8) , used to score the symptoms of anxiety or depression Quality of life assessment: will be assessed by the Patient assessment of constipation-quality of life questionnaire|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 1-Assess psychiatric disorders among patients with anorectal dyssynergia | Review the different types of psychiatric disorders in patients have diagnosed anorectal dyssynergia using SCID-5 ,anxiety and depression Hamilton score (from 0-4,zero refer to no symptoms ,4 refer to sever symptoms ), the summation of them show the type and severity of the condition | through study completion, an average of 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The impact of anorectal dyssynergia on the quality of the life | By using survey contain 36 short question about the quality of the life of the patient with anorectal dyssynergia and compare the answer with those of normal people | Through study completion, an average of 1 year |