Simulated defecation training. The goal of this training is to teach the subject to expel an artificial stool in
the laboratory using the correct technique. This manoeuvre is performed by placing a 50 mlwater-filled
balloon in the rectum or by using an artificial stool such as Fecom [8,11]. After placement of balloon in the
left lateral position, the subject is asked to sit on acommodeand to attempt defecation. While the subject
attempts to pass the balloon, assistance is provided, and the subject is taughthowto relax the pelvic floor
muscles and to adopt a correct posture and use appropriate breathing techniques. If the subject is unable
to expel the balloon, gentle traction is applied to the balloon to supplement the patient’s efforts.
Gradually, the subject learns how to coordinate the defecation manoeuvre and to expel the balloon