The goal of a new study published in the International Journal of Colorectal Disease was to elucidate alterations of the autonomous enteric nervous system at the molecular level in patients with obstructed defecation, who represent one of the most predominant groups among constipated patients. This study analyzed full-thickness rectal wall samples of patients with obstructed defecation and compared them with samples from controls. Differential gene expression analyses by RNA-Seq transcriptome profiling were performed. The results revealed that genes associated with the enteric nervous system functions were significantly downregulated in patients with obstructed defecation. The affected functions included developmental processes and synaptic transmission. Hence, it was concluded that obstructed defecation may represent an enteric neuropathy, comparable to Hirschsprung’s disease and slow-transit constipation.