Anorectal disorders: Fecal impaction, structural disorders of the pelvic floor and anorectal pain syndromes

Anorectal disorders are very common with a prevalence of 8.1% in a 2021 multinational internet symptom survey which included fecal incontinence and anorectal pain syndromes. This figure did not include dyssynergic defecation which requires physiological testing for diagnosis. These disorders significantly affect quality of life. This chapter discusses several common anorectal entities including fecal impaction, structural disorders of the pelvic floor and anorectal pain syndromes. It is important to note that there is much overlap between these conditions, and the distinction between organic and “functional” conditions is blurred. Many structural disorders also occur in asymptomatic individuals and therefore correlating symptoms with abnormal structure and/or function is often challenging. These conditions will be presented separately, and algorithms for clinical approach and management are described.