Document Detail


Long-term efficacy of biofeedback therapy for dyssynergic defecation: randomized controlled trial.
MedLine Citation:
PMID:  20179692     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Satish S C Rao; Jessica Valestin; C Kice Brown; Bridget Zimmerman; Konrad Schulze
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural     Date:  2010-02-23
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  105     ISSN:  1572-0241     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-07     Completed Date:  2010-05-06     Revised Date:  2014-09-14    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  890-6     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Biofeedback, Psychology*
Constipation / physiopathology,  therapy*
Diet Therapy
Exercise Therapy
Female
Gastrointestinal Transit
Humans
Laxatives / therapeutic use
Male
Manometry
Middle Aged
Regression Analysis
Treatment Outcome
Grant Support
ID/Acronym/Agency:
R01 DK 57100-05/DK/NIDDK NIH HHS; R01 DK057100/DK/NIDDK NIH HHS; RR00059/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Laxatives
Comments/Corrections
Comment In:
Gastroenterology. 2011 May;140(5):1682-5   [PMID:  21439983 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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