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Colon Some patients with a DD may have normal results on balloon expulsion test, so defecography should be performed when clinically indicated Colonic transit is delayed in the majority of patients who have functional DDs Anorectal function tests False-positive and false-negative results may occur, so results must be interpreted in the context of the clinical features In up to 20% of healthy persons, the anal sphincter paradoxi cally contracts instead of relaxes during evacuation constipation may strain excessively during defecation and cause stretch injury to the pudendal nerve, soft tissue laxity, and excessive perineal descent

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