{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T17:11:22Z","timestamp":1769015482458,"version":"3.49.0"},"reference-count":40,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,4,10]],"date-time":"2023-04-10T00:00:00Z","timestamp":1681084800000},"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":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Patients with obstructed defecatory symptoms (ODS) are commonly referred to either gastroenterologists (GE) or colorectal surgeons (CS). Further management of these patients may be impacted by this choice of referral.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An online survey of specialist practice was disseminated to GE and CS in Australia and New Zealand. A case vignette of a patient presenting with ODS was described, with multiple subsequent scenarios designed to delineate the responder's preferred approach to management of this patient.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>A total of 107 responders participated in the study, 62 CS and 45 GE. For a female patient with ODS not responding to pharmacological treatment, GE were more likely than CS to refer patients for anorectal manometry, while CS were more likely to refer for dynamic imaging. A quarter of CS and GE referred patients directly to pelvic floor physiotherapy, without any pre\u2010treatment testing. Knowing the result of dynamic imaging, especially if a rectocele was demonstrated, substantially influenced management for both of the specialties: GE became more likely to refer the patients for CS consultation and less likely to refer directly for biofeedback or physiotherapy and CS were more likely to opt for an operative pathway over conservative management than they were prior to knowledge of the imaging findings. The majority (&gt;75%) of GE and CS did not find it necessary to obtain a gynecological consultation, even in the presence of a rectocele.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Inferences<\/jats:title><jats:p>Practice variation across medical specialties affects diagnostic and management recommendations for patients with ODS, impacting treatment pathways. Our findings provide an incentive toward establishing interdisciplinary, uniform, management guidelines.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.14592","type":"journal-article","created":{"date-parts":[[2023,4,10]],"date-time":"2023-04-10T14:15:48Z","timestamp":1681136148000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The patient with obstructed defecatory symptoms: Management differs considerably between physicians and surgeons"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8590-6271","authenticated-orcid":false,"given":"Yoav","family":"Mazor","sequence":"first","affiliation":[{"name":"Neurogastroenterology Unit, Department of Gastroenterology Royal North Shore Hospital  St Leonards New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret","family":"Schnitzler","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Royal North Shore Hospital  St Leonards New South Wales Australia"},{"name":"Head of Northern Clinical School University of Sydney  New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0565-4938","authenticated-orcid":false,"given":"Michael","family":"Jones","sequence":"additional","affiliation":[{"name":"School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences Macquarie University  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anastasia","family":"Ejova","sequence":"additional","affiliation":[{"name":"School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences Macquarie University  Sydney New South Wales Australia"},{"name":"School of Psychology University of Adelaide  Adelaide Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allison","family":"Malcolm","sequence":"additional","affiliation":[{"name":"Neurogastroenterology Unit, Department of Gastroenterology Royal North Shore Hospital  St Leonards New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,4,10]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2004.04114.x"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0b013e31822cb5c2"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mcg.0000135929.78074.8c"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(93)90896-K"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000599"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.02.009"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.12751"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.scrs.2015.12.002"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2004.00526.x"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-008-9434-x"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-008-9378-1"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02055127"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm.2013.19.1.85"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v21.i1.1"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v18.i36.4994"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.13775"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-018-1921-z"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm16060"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2005.05.015"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12520"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2014-308835"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12859"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.02.009"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.15039"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14438"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02237190"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2013.11.013"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.30.12.1737"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.12595"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.12213"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2013.12.002"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.14833"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-019-04001-z"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.13006"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000889"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.asjsur.2017.05.002"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD012975"},{"key":"e_1_2_9_40_1","first-page":"427","article-title":"Response rates in GP surveys \u2013 trialling two recruitment strategies","volume":"40","author":"Bonevski B","year":"2011","journal-title":"Aust Fam Physician"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-012-1425-7"}],"container-title":["Neurogastroenterology &amp; Motility"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nmo.14592","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T01:17:01Z","timestamp":1692235021000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nmo.14592"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,10]]},"references-count":40,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1111\/nmo.14592"],"URL":"https:\/\/doi.org\/10.1111\/nmo.14592","archive":["Portico"],"relation":{},"ISSN":["1350-1925","1365-2982"],"issn-type":[{"value":"1350-1925","type":"print"},{"value":"1365-2982","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,10]]},"assertion":[{"value":"2022-09-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14592"}}