ABSTRACT

Objective:

The aim of this study was to determine the efficacy of adding a foot stool to help facilitate defecation in patients with fecal outlet obstruction.

Methods:

Patients (n=53) who experienced evacuation difficulties between June and October 2016 were enrolled in this prospective non-randomized single group study. Cinedefecography was performed with and without a foot stool. Anorectal angle (ARA), perineal plane distance (PPD), and puborectalis length (PRL) during rest and straining in both positions were measured from the radiographs. Rectal pressure was measured with the lateral position and sitting with and without a foot stool.

Results:

There was no significant difference between with and without a foot stool in ARA, PPD and PRL. In the upper body bent forward group, the time to evacuation was significantly shorter with a foot stool compared to without a foot stool (123 vs 91 sec, p=0.04). The difference of rectal pressure between the lateral position and sitting position significantly increased with a foot stool compared to without a foot stool (22.1 vs 16.7 mmH2O, p<0.01). The difference of rectal pressure between with and without a foot stool increased in the upper body bent forward position compared to the upright sitting position (5.4 vs 1.9 mmH2O, p<0.01).

Conclusion:

The findings suggest that using a foot stool with structure is a more efficient method for defecation. However, the upper body bent forward position is also important. This technique may be useful for retraining patients with constipation.