Korean J Gastroenterol.  2003 Mar;41(3):190-195.

Contribution of Posture to Anorectal Angle and Perineal Descent on Defecography

• Cho YK
• Kim CS
• Koo ES
• Yun JW
• Kim JW
• Lee JH
• Park CY
• Sohn CI
• Jeon WK
• Kim BI
• Choi DI

Abstract

BACKGROUND/AIMS: Pelvic floor location and mobility vary according to the defecation posture. Authors investigated possible effects of the change of defecation posture on the patients with pelvic outlet obstructive constipation among patients with chronic idiopathic constipation. METHODS: Subjects included in the study were 32 patients with pelvic outlet obstructive constipation (24 spastic pelvic floor syndrome, 8 perineal descent syndrome). From all the subjects, defecographies of both resting and straining phases were obtained for three different postures (sitting, leg elevating and squatting). RESULTS: In the patients with spastic pelvic floor syndrome, the anorectal angles of straining phase in squatting position were 117.93+/-3.58 degrees and 118.2+/-4.94 degrees, respectively. These values were significantly greater than those measured in sitting position (resting 93.75+/-6.74 degrees, straining 95.17+/-7.77 degrees) and leg elevating position (resting 99.42+/-4.79 degrees, straining 98.67+/-5.76 degrees) (p<0.01, p<0.01, respectively). In addition, in the patients with perineal descent syndrome, perineal descent in squatting position revealed no significant differences compared with sitting and leg elevating positions. CONCLUSIONS: In patients with spastic pelvic floor syndrome, squatting position increases the anorectal angle. Although further studies are needed to support our ideas, this study demonstrates that patients with spastic pelvic floor syndrome can have benefit from the Korean traditional defecation posture by increasing the anorectal angle.

Keyword

Anorectal angle; Perineal descent; Defecography; Change of defecation posture