Clinical trial NCT06128031: Psychiatric Disorder in Anorectal Dyssynergia
Official title: Psychiatric Assessment of Patients With Anorectal Dyssynergia and the Impact on the Quality of Life
Study type: OBSERVATIONAL
Overall status: NOT_YET_RECRUITING
Conditions: Anorectal Disorder
Psychiatric Disorder
Lead sponsor: Assiut University
Sponsor class: OTHER
First posted: 2023-11-13
Enrollment: 100
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Observational model: CASE_CONTROL
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: all population from 18 years which suffer from chronic conistipation and diagnosed anorectal dyssynergia by rectal manometry or defecogram

Brief summary: 1. evaluate psychiatric disorders among patients with anorectal dyssynergia
2. evaluate the effect of delayed diagnosis of anorectal dyssynergia on the quality of the life

Detailed description: 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.

Eligibility criteria: 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

Primary outcomes:
measure: 1-Assess psychiatric disorders among patients with anorectal dyssynergia
timeFrame: through study completion, an average of 1 year
Secondary outcomes:
measure: The impact of anorectal dyssynergia on the quality of the life
timeFrame: Through study completion, an average of 1 year
Other outcomes:
Locations:
Study officials:
affiliation: Assiut University
name: Bahaa osman, teacher
role: STUDY_DIRECTOR
References:
citation: Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC. Functional bowel disorders. Gastroenterology. 2006 Apr;130(5):1480-91. doi: 10.1053/j.gastro.2005.11.061.
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citation: Rao SS, Tuteja AK, Vellema T, Kempf J, Stessman M. Dyssynergic defecation: demographics, symptoms, stool patterns, and quality of life. J Clin Gastroenterol. 2004 Sep;38(8):680-5. doi: 10.1097/01.mcg.0000135929.78074.8c.
citation: Rao SS, Seaton K, Miller MJ, Schulze K, Brown CK, Paulson J, Zimmerman B. Psychological profiles and quality of life differ between patients with dyssynergia and those with slow transit constipation. J Psychosom Res. 2007 Oct;63(4):441-9. doi: 10.1016/j.jpsychores.2007.05.016. Epub 2007 Aug 1.
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citation: Williams JB. A structured interview guide for the Hamilton Depression Rating Scale. Arch Gen Psychiatry. 1988 Aug;45(8):742-7. doi: 10.1001/archpsyc.1988.01800320058007.
citation: Hosseinzadeh ST, Poorsaadati S, Radkani B, Forootan M. Psychological disorders in patients with chronic constipation. Gastroenterol Hepatol Bed Bench. 2011 Summer;4(3):159-63.