C Van de Bruaene, H De Schepper, M Surmont, D Van de Putte, S Van den Broeck, G Bislenghi, K Boon, P Casteels, J -B Cornille, D De Looze, M A Denis, A François, I Gijsen, J Geldof, B Van Geluwe, I Geraerts, M Hanssens, S Kindt, N Komen, D Meerhout, S Nullens, N Poortmans, P Pletinckx, K Raymenants, H Ruymbeke, A Segaert, S Stockman, J Stijns, T Van Aggelpoel, L Vandenplas, P Roelandt
{"title":"Guideline on Pelvic Floor Disorders: consensus on Obstructed Defecation Syndrome (ODS).","authors":"C Van de Bruaene, H De Schepper, M Surmont, D Van de Putte, S Van den Broeck, G Bislenghi, K Boon, P Casteels, J -B Cornille, D De Looze, M A Denis, A François, I Gijsen, J Geldof, B Van Geluwe, I Geraerts, M Hanssens, S Kindt, N Komen, D Meerhout, S Nullens, N Poortmans, P Pletinckx, K Raymenants, H Ruymbeke, A Segaert, S Stockman, J Stijns, T Van Aggelpoel, L Vandenplas, P Roelandt","doi":"10.51821/89.2.15231","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and aims: </strong>Obstructed defecation syndrome (ODS) is a multifactorial condition that significantly impairs quality of life and presents diagnostic and therapeutic challenges due to the interaction of functional and anatomical factors. This initiative aimed to develop a Belgian consensus and a diagnostic-therapeutic algorithm to support effective clinical management of ODS.</p><p><strong>Methods: </strong>A Belgian steering group of gastroenterologists and colorectal surgeons (n=6) conducted a Delphi consensus process. Based on a structured literature review, 82 statements were drafted and discussed during three online voting rounds. Consensus was defined as ≥80% agreement, and evidence strength was graded using the GRADE system.</p><p><strong>Results: </strong>Thirty-one experts participated, including gastroenterologists, colorectal surgeons, gynecologists, and physiotherapists. Sixty-two final statements were formulated, of which 46 were endorsed. ODS was defined as a disorder of anorectal evacuation, with functional and structural components often coexisting. Symptoms overlap with functional constipation, IBS-C, and fecal incontinence, and quality of life is substantially impaired. Diagnosis requires multimodal evaluation, including digital rectal examination and anorectal testing. First-line treatment consists of conservative measures such as lifestyle optimization, laxatives, and pelvic floor re-education. Surgery is reserved for selected patients with refractory symptoms and significant anatomical abnormalities. Tailored surgical approaches are supported for rectocele, rectal prolapse, and pelvic organ prolapse, whereas sacral nerve stimulation is not routinely recommended.</p><p><strong>Conclusion: </strong>These consensus statements provide practical guidance for the diagnosis and management of ODS. Conservative therapy remains the cornerstone, with surgery reserved for selected cases. Areas lacking consensus warrant further research.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"89 2","pages":"385-405"},"PeriodicalIF":1.2000,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta gastro-enterologica Belgica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.51821/89.2.15231","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background and aims: Obstructed defecation syndrome (ODS) is a multifactorial condition that significantly impairs quality of life and presents diagnostic and therapeutic challenges due to the interaction of functional and anatomical factors. This initiative aimed to develop a Belgian consensus and a diagnostic-therapeutic algorithm to support effective clinical management of ODS.
Methods: A Belgian steering group of gastroenterologists and colorectal surgeons (n=6) conducted a Delphi consensus process. Based on a structured literature review, 82 statements were drafted and discussed during three online voting rounds. Consensus was defined as ≥80% agreement, and evidence strength was graded using the GRADE system.
Results: Thirty-one experts participated, including gastroenterologists, colorectal surgeons, gynecologists, and physiotherapists. Sixty-two final statements were formulated, of which 46 were endorsed. ODS was defined as a disorder of anorectal evacuation, with functional and structural components often coexisting. Symptoms overlap with functional constipation, IBS-C, and fecal incontinence, and quality of life is substantially impaired. Diagnosis requires multimodal evaluation, including digital rectal examination and anorectal testing. First-line treatment consists of conservative measures such as lifestyle optimization, laxatives, and pelvic floor re-education. Surgery is reserved for selected patients with refractory symptoms and significant anatomical abnormalities. Tailored surgical approaches are supported for rectocele, rectal prolapse, and pelvic organ prolapse, whereas sacral nerve stimulation is not routinely recommended.
Conclusion: These consensus statements provide practical guidance for the diagnosis and management of ODS. Conservative therapy remains the cornerstone, with surgery reserved for selected cases. Areas lacking consensus warrant further research.
期刊介绍：
The Journal Acta Gastro-Enterologica Belgica principally publishes peer-reviewed original manuscripts, reviews, letters to editors, book reviews and guidelines in the field of clinical Gastroenterology and Hepatology, including digestive oncology, digestive pathology, as well as nutrition. Pure animal or in vitro work will not be considered for publication in the Journal. Translational research papers (including sections of animal or in vitro work) are considered by the Journal if they have a clear relationship to or relevance for clinical hepato-gastroenterology (screening, disease mechanisms and/or new therapies). Case reports and clinical images will be accepted if they represent an important contribution to the description, the pathogenesis or the treatment of a specific gastroenterology or liver problem. The language of the Journal is English. Papers from any country will be considered for publication. Manuscripts submitted to the Journal should not have been published previously (in English or any other language), nor should they be under consideration for publication elsewhere. Unsolicited papers are peer-reviewed before it is decided whether they should be accepted, rejected, or returned for revision. Manuscripts that do not meet the presentation criteria (as indicated below) will be returned to the authors. Papers that go too far beyond the scope of the journal will be also returned to the authors by the editorial board generally within 2 weeks. The Journal reserves the right to edit the language of papers accepted for publication for clarity and correctness, and to make formal changes to ensure compliance with AGEB’s style. Authors have the opportunity to review such changes in the proofs.
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