{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T08:33:39Z","timestamp":1782290019765,"version":"3.54.5"},"reference-count":22,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,4,13]],"date-time":"2020-04-13T00:00:00Z","timestamp":1586736000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Patients with pelvic floor myofascial pain (PFMP) have puborectalis tenderness on digital rectal examination (DRE). Little is known about its significance to anorectal function in patients presenting with constipation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To characterize demographics, clinical characteristics, findings on anorectal manometry (ARM), diagnosis of rectal evacuation disorder (RED), colonic transit [normal (NTC) or slow (STC)], and imaging in constipated patients with PFMP and compare these features to constipation without PFMP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed an electronic medical records review of patients with constipation evaluated by a single gastroenterologist between January 2008 and February 2019. Patients with PFMP were compared to controls with constipation but without PFMP (1:2 ratio).<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>A total of 98 PFMP cases and 196 controls were identified. Constipated patients with PFMP were more likely to have RED [OR 7.59 (3.82\u201015.09), <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01]; controls were more likely to have either NTC [OR 4.25 (1.45\u201012.42), <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01] or STC [OR 3.57 (1.45\u20108.78), <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01]. RED in patients with PFMP is supported by comparison to controls: On DRE, they had increased resting tone [OR 2.25 (1.33\u20103.83), <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01] and paradoxical contraction of the puborectalis upon simulated evacuation [OR 3.41 (1.94\u20106.00), <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01]; on ARM, they had higher maximum resting pressure (102.9\u00a0mmHg vs 90.7\u00a0mmHg, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01) and lower rectoanal pressure gradient (\u221239.4\u00a0mmHg vs \u221224.7\u00a0mmHg, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions\/Inferences<\/jats:title><jats:p>In constipated patients, PFMP is highly associated with RED. Its presence provides a valuable clue regarding the etiology of a patient's constipation; it should be assessed in all patients with constipation and should also be an additional target for management.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.13845","type":"journal-article","created":{"date-parts":[[2020,4,13]],"date-time":"2020-04-13T07:14:14Z","timestamp":1586762054000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Clinical presentation and characteristics of pelvic floor myofascial pain in patients presenting with constipation"],"prefix":"10.1111","volume":"32","author":[{"given":"Andy","family":"Liu","sequence":"first","affiliation":[{"name":"Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER) Division of Gastroenterology and Hepatology Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8548-9228","authenticated-orcid":false,"given":"Victor","family":"Chedid","sequence":"additional","affiliation":[{"name":"Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER) Division of Gastroenterology and Hepatology Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao J.","family":"Wang","sequence":"additional","affiliation":[{"name":"Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER) Division of Gastroenterology and Hepatology Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priya","family":"Vijayvargiya","sequence":"additional","affiliation":[{"name":"Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER) Division of Gastroenterology and Hepatology Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6472-7514","authenticated-orcid":false,"given":"Michael","family":"Camilleri","sequence":"additional","affiliation":[{"name":"Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER) Division of Gastroenterology and Hepatology Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,4,13]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2018.06.014"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11894-017-0554-0"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.5009\/gnl17172"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2016.08.011"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.07.020"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2009.12.040"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12520"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13510"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2009.01442.x"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640613518774"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02049867"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.4321\/S1130-01082009000700003"},{"issue":"3","key":"e_1_2_11_14_1","first-page":"e13658","article-title":"Descending perineum syndrome causes ~10% of constipation in 297 adults in referral center","volume":"31","author":"Wang XJ","year":"2019","journal-title":"Neurogastroenterol Motil"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2010.11.001"},{"key":"e_1_2_11_16_1","first-page":"A5976","article-title":"Chronic constipation and rectal functional investigations. 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