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New research · Gastroenterology
Acta gastro-enterologica Belgica · 2d
GuidelineActa gastro-enterologica Belgica · 2026

Guideline on Pelvic Floor Disorders: consensus on Obstructed Defecation Syndrome (ODS).

C Van de Bruaene, H De Schepper, M Surmont … P Roelandt
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GastroenterologyGuideline

Belgian experts endorsed 46 statements for obstructed defecation syndrome management.

Guideline on Pelvic Floor Disorders: consensus on Obstructed Defecation Syndrome (ODS).

C Van de Bruaene et al. · Acta gastro-enterologica Belgica · 2026
Background

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.

Purpose

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.

n = 6
46
Results
recommendations experts agreed on for treating difficulty emptying bowels
n = 6
More results

Thirty-one experts participated, including gastroenterologists, colorectal surgeons, gynecologists, and physiotherapists.

Symptoms overlap with functional constipation, IBS-C, and fecal incontinence, and quality of life is substantially impaired.

More results

Diagnosis requires multimodal evaluation, including digital rectal examination and anorectal testing.

Surgery is reserved for selected patients with refractory symptoms and significant anatomical abnormalities.

“
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.

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