Long-term efficacy of biofeedback therapy for dyssynergic defecation

Randomized controlled trial

Satish Sanku Chander Rao, Jessica Valestin, C. Kice Brown, Bridget Zimmerman, Konrad Schulze

Research output: Contribution to journalArticle

100 Citations (Scopus)

Abstract

Objectives: 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.Methods: 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.Results: 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.Conclusions: Biofeedback therapy provided sustained improvement of bowel symptoms and anorectal function in constipated subjects with dyssynergic defecation, whereas standard therapy was largely ineffective.

Original languageEnglish (US)
Pages (from-to)890-896
Number of pages7
JournalAmerican Journal of Gastroenterology
Volume105
Issue number4
DOIs
StatePublished - Apr 1 2010

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Defecation
Randomized Controlled Trials
Ataxia
Therapeutics
Outcome Assessment (Health Care)
Diet Therapy
Exercise Therapy
Laxatives
Intention to Treat Analysis
Manometry
Visual Analog Scale

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Long-term efficacy of biofeedback therapy for dyssynergic defecation : Randomized controlled trial. / Rao, Satish Sanku Chander; Valestin, Jessica; Brown, C. Kice; Zimmerman, Bridget; Schulze, Konrad.

In: American Journal of Gastroenterology, Vol. 105, No. 4, 01.04.2010, p. 890-896.

Research output: Contribution to journalArticle

Rao, Satish Sanku Chander ; Valestin, Jessica ; Brown, C. Kice ; Zimmerman, Bridget ; Schulze, Konrad. / Long-term efficacy of biofeedback therapy for dyssynergic defecation : Randomized controlled trial. In: American Journal of Gastroenterology. 2010 ; Vol. 105, No. 4. pp. 890-896.
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