One form of treatment is Cognitive behavioral therapy which promotes desensitization methods.

Parcopresis can be described as "an inability to defecate when other people are perceived or likely to be around (e.g. in the same public toilet, house or building)". This inability restricts the sufferer's lifestyle by requiring that s/he defecate only in a limited number of 'safe' places, with less severe presentations also permitting defecation in places where the person is unknown and unlikely to become known in the future, such that any embarrassment is unlikely to have consequences lasting beyond the defecative episode itself (in effect a mundane application of the reasoning that the "game" in question is non-iterative). The level of restriction varies depending on the severity of each sufferer's condition but in extreme cases it can force people to give up their jobs, avoid holidays they would love to take, and generally dictate and limit most aspects of their lives.

It affects both men and women, of all ages and backgrounds. It is not clear how many people suffer with the condition, and level of severity is a key factor as some people may not find it affects their lives, while others find their lives are dictated by its demands.

Initial steps to alleviate anismus include dietary adjustments and simple adjustments when attempting to defecate. Supplementation with a bulking agent such as psyllium 3500 mg per day will make stool more bulky, which decreases the effort required to evacuate. Similarly, exercise and adequate hydration may help to optimise stool form. The anorectal angle has been shown to flatten out when in a squatting position, and is thus recommended for patients with functional outlet obstruction like anismus. If the patient is unable to assume a squatting postures due to mobility issues, a low stool can be used to raise the feet when sitting, which effectively achieves a similar position.

Treatments for anismus include biofeedback retraining, botox injections, and surgical resection. Anismus sometimes occurs together with other conditions that limit (see contraindication) the choice of treatments. Thus, thorough evaluation is recommended prior to treatment.

Biofeedback training for treatment of anismus is highly effective and considered the gold standard therapy by many.

Others however, reported that biofeedback had a limited therapeutic effect.

Injections of botulin toxin type-A into the puborectalis muscle are very effective in the short term, and somewhat effective in the long term. Injections may be helpful when used together with biofeedback training.

Historically, the standard treatment was surgical resection of the puborectalis muscle, which sometimes resulted in fecal incontinence. Recently, partial resection (partial division) has been reported to be effective in some cases.

The Rome classification diagnostic criteria for functional defecation disorders is as follows:

The diagnostic criteria for dyssynergic defecation is given as "inappropriate contraction of the pelvic floor

or less than 20% relaxation of basal resting sphincter pressure with adequate propulsive forces during attempted defecation."

The diagnostic criteria for inadequate defecatory Propulsion is given as "inadequate propulsive forces with or without inappropriate contraction or less than 20% relaxation of the anal sphincter during attempted defecation."

The Rome criteria recommend that anorectal testing is not usually indicated in patients with symptoms until patients have failed conservative

treatment (e.g., increased dietary fiber and liquids; elimination

of medications with constipating side effects

whenever possible).

Various investigations have been recommended in the diagnosis of anisumus.

It appears that paruresis involves a tightening of the sphincter and/or bladder neck due to a sympathetic nervous system response. The adrenaline rush that produces the involuntary nervous system response probably has peripheral and central nervous system involvement. The internal urethral sphincter (smooth muscle tissue) or the external urethral sphincter (striated muscle), levator ani (especially the pubococcygeus) muscle area, or some combination of the above, may be involved. It is possible that there is an inhibition of the detrusor command through a reflex pathway as well. The pontine micturition center (Barrington's nucleus) also may be involved, as its inhibition results in relaxation of the detrusor and prevents the relaxation of the internal sphincter.

Some people have brief, isolated episodes of urinary difficulty in situations where other people are in close proximity. Paruresis, however, goes beyond simple shyness, embarrassment, fear of exposure, or fear of being judged for not being able to urinate. Other people may find that they are unable to urinate while in moving vehicles, or are fixated on the sounds of their urination in quiet restrooms or residential settings. In severe cases, a person with paruresis can urinate only when alone at home or through the process of catheterization.

Although most sufferers report that they developed the condition in their teenage years, it can strike at any age. Also, because of the differing levels of severity from one person to another, some people first experience the problem when they "lock up" for the first time attempting to produce a sample for a drug test or alcohol test. Many women are unaware that they, too, are subject to paruresis; articles about women and urination emphasize other female urinary dysfunctions, such as urinary incontinence or frequent urination.

Some people cope by deliberately holding in their urine, by refraining from drinking liquids, or locating unoccupied or single-occupancy public bathrooms.

Severe cases of this disorder can have highly restricting effects on a person's life. In moderate to severe cases, overcoming paruresis can be extremely difficult without the help of a psychologist, therapist or support groups. Severe sufferers may not be willing to travel far from their home or be able to form intimate relationships. Others cannot urinate even in their own home if someone else can be heard to be there.

Sometimes paruresis can be overcome by someone nearby turning a water tap/faucet on and letting the water run noisily.