Biofeedback for Functional Constipation
07/05/06 05:46 PM
Biofeedback. Hu and colleagues evaluated the role of biofeedback in patients with functional constipation. In this prospectively designed study, patients meeting the Rome II criteria for chronic constipation were randomized to a usual care group (lifestyle and dietary recommendations along with general advice) or a biofeedback group (usual care and 6 sessions of biofeedback for presumed pelvic floor dysfunction every 2 weeks). Sixty patients entered the study and were randomly and equally assigned to 1 of the 2 treatment groups (95% women; mean age = 44 years).
Patients were not stratified on the basis of symptoms and neither anorectal manometry nor balloon expulsion testing were performed. After treatment, the number of complete spontaneous bowel movements increased in both groups to similar frequencies (1.3 per week at baseline to 2.5 per week). However, the biofeedback group had a significant reduction in straining, feelings of incomplete evacuation, bloating, and laxative use (P values not provided). The results of this study are intriguing because they support the view that pelvic floor dysfunction is a significant cause of constipation, either alone or in conjunction with normal-transit or slow-transit constipation. Thus, a treatment program for presumed pelvic floor dysfunction can yield significant benefits without the need to objectively measure patients using anorectal manometry.
Hu WH, Li JH, Chan AO, Wong NY, Wong SH, Hui WM. Biofeedback is an effective treatment for functional constipation: a randomized controlled study. Gastroenterology. 2006;130:A-287. [#S1931]