Role of biofeedback in patients with functional constipation

ABSTRACT

Functional constipation with paradoxical puborectalis contraction is still a distressing problem. The aim of this study is to assess the effect of biofeedback therapy in managing such condition. Twenty one patients with any degree of paradoxical puborectalis contraction. [PPC] measured with EMG and /or defecography were included. The patients had ten outpatient training sessions with manometry based audiovisual feedback. All patients were followed up for a median 5 [3-12] months. Three patients couldn't continue the coarse. Eleven patients stated they had improved rectal emptying. A good result was associated with increased stool frequency [P< 0.05], reduction of laxative use [P < 0.02]. A long symptom duration and laxative use were related to poor results. The improved group had less perincal descent [P < 0.02] and a prominent puborectalis impression tended to he more common [P < 0.02]. Conclusion: Biofeedback was successful in 73.3% of patients with PPC with a treatment effect lasting for more than 3 months. The results suggest that biofeedback should be used as the initial treatment for constipated patients with PPC