Towards an understanding of defecation disorders: pathophysiology, epidemiology, and clinical implications

Defecation disorders, such as constipation, i.e., troublesome defecation or fecal incontinence (FI), i.e., involuntary loss of feces, are common diseases troubling the general population. They have an extremely negative impact on the quality of life and socioeconomic status. Despite recent improvements in techniques that can be profitable for patients with defecatory problems, the recognition, diagnosis, and treatment of these dysfunctions remain troublesome, as indicated by the high prevalence and posttreatment recurrence of the defecation disorders. The suboptimal treatment possibly results from the knowledge gap, which still exists in the field of anorectal pathophysiology. Also, the current state of the art, which approves symptom-based approaches to treat diseases, instead of targeting the cause of the disease, hampers the efficacy of the treatment. With the findings described in this thesis, we contributed to improved knowledge of anorectal physiology and the optimization of different facets of medical care in patients with defecatory problems.