Long-term efficacy of biofeedback therapy for dyssynergic defecation: randomized controlled trial

Satish S C Rao; Jessica Valestin; C Kice Brown; Bridget Zimmerman; Konrad Schulze

doi:10.1038/ajg.2010.53

Back

Journal article

Peer reviewed

Long-term efficacy of biofeedback therapy for dyssynergic defecation: randomized controlled trial

Satish S C Rao, Jessica Valestin, C Kice Brown, Bridget Zimmerman and Konrad Schulze

The American journal of gastroenterology, Vol.105(4), pp.890-896

04/2010

DOI: 10.1038/ajg.2010.53

PMCID: PMC3910270

PMID: 20179692

View Online

Abstract

Although biofeedback therapy is effective in the short-term management of dyssynergic defecation, its long-term efficacy is unknown. Our aim was to compare the 1-year outcome of biofeedback (manometric-assisted pelvic relaxation and simulated defecation training) with standard therapy (diet, exercise, laxatives) in patients who completed 3 months of either therapy. Stool diaries, visual analog scales (VASs), colonic transit, anorectal manometry, and balloon expulsion time were assessed at baseline, and at 1 year after each treatment. All subjects were seen at 3-month intervals and received reinforcement. Primary outcome measure (intention-to-treat analysis) was a change in the number of complete spontaneous bowel movements (CSBMs) per week. Secondary outcome measures included bowel symptoms, changes in dyssynergia, and anorectal function. Of 44 eligible patients with dyssynergic defecation, 26 agreed to participate in the long-term study. All 13 subjects who received biofeedback, and 7 of 13 who received standard therapy, completed 1 year; 6 failed standard therapy. The number of CSBMs per week increased significantly (P<0.001) in the biofeedback group but not in the standard group. Dyssynergia pattern normalized (P<0.001), balloon expulsion time improved (P=0.0009), defecation index increased (P<0.001), and colonic transit time normalized (P=0.01) only in the biofeedback group. Biofeedback therapy provided sustained improvement of bowel symptoms and anorectal function in constipated subjects with dyssynergic defecation, whereas standard therapy was largely ineffective.

Manometry

Humans

Middle Aged

Biofeedback, Psychology

Male

Treatment Outcome

Laxatives - therapeutic use

Constipation - physiopathology

Exercise Therapy

Gastrointestinal Transit

Regression Analysis

Constipation - therapy

Female

Diet Therapy

Details

Title: Subtitle: Long-term efficacy of biofeedback therapy for dyssynergic defecation: randomized controlled trial
Creators: Satish S C Rao - Department of Gastroenterology, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242-1009, USA. satish-rao@uiowa.edu
Jessica Valestin
C Kice Brown
Bridget Zimmerman
Konrad Schulze
Resource Type: Journal article
Publication Details: The American journal of gastroenterology, Vol.105(4), pp.890-896
DOI: 10.1038/ajg.2010.53
PMID: 20179692
PMCID: PMC3910270
NLM abbreviation: Am J Gastroenterol
ISSN: 0002-9270
eISSN: 1572-0241
Publisher: United States
Grant note: R01 DK057100 / NIDDK NIH HHS M01 RR000059 / NCRR NIH HHS R01 DK 57100-05 / NIDDK NIH HHS RR00059 / NCRR NIH HHS
Language: English
Date published: 04/2010
Academic Unit: Biostatistics; Internal Medicine
Record Identifier: 9983997335702771

Metrics

75 Record Views

140 Times Cited - Web of Science

See more details