What is a Defecating proctogram (Defecogram)?

A defecating proctogram, also known as a defecography or a defagram, is used for functional imaging of the muscles and tubular structures used in defecation. It is a study commonly used to demonstrate the functional problem in a person with pelvic floor dysfunction, or a rectocele.  These symptoms can be constipation, incomplete evacuation, incontinence, mucous discharge, or perineal pain.

What is the Preparation for a Defecogram?

You will need to do a bowel prep so that the bowels are empty during the procedure. You will be given a sheet of instructions from the radiology department at the hospital that does the test.

What is the Procedure for a Defecogram?

During this study, the patient is given an enema of a thick liquid that can be detected with x-ray. This is done with a very small rectal probe. A special x-ray video records the movement of the pelvic floor muscles and the rectum while the individual attempts to empty the liquid from the rectum while sitting on a special commode. Normally the pelvic floor relaxes allowing the rectum to straighten and the liquid to pass out of the rectum.

What can be Learned From a Defecogram?

The defecogram is used to diagnose functional defects. This study will demonstrate the entire straining sequence, and if the pelvic floor muscles are not relaxing appropriately preventing passage of the liquid. The defecating proctogram is also useful to show if the rectum is prolapsed (folding in on itself), or there is an intussesception. This is helpful if surgical correction is warranted.