Background: Dyssynergic defecation is a major cause of chronic functional constipation as a
common digestive complaint. We clinically evaluated the effects of biofeedback therapy on the pelvic
floor motion indices through magnetic resonance (MR) defecography, quality of life and depression
in patients with dyssynergic defecation.
Methods: In this clinical trial study, among patients referring to the Colorectal Clinic of Hazrat
Rasoul Hospital, 22 subjects were randomly assigned into two equal groups (n= 11) to receive either
standard only or biofeedback and standard therapy. Dynamic changes of the pelvic floor were measured
by MR defecography. During the simulated defecation, two MR defecography dynamic indices
including abnormal anorectal angle change and perineal descent were measured before and after
treatment. The effects of biofeedback therapy on patients’ symptoms, quality of life and severity of
depression were assessed and compared with the standard therapy. Statistical analysis was carried
out using independent _t-test and Mann-Whitney test.
Results: Paradox index (p< 0.001), perineal descent index (p< 0.001), depression (p< 0.1), physical
function (p< 0.001), vitality (p< 0.001) and role emotion (p< 0.001) significantly improved in the
biofeedback therapy group in contrast to the standard therapy SDT group.
Conclusion: Biofeedback therapy appears to be effective in improving symptoms of functional
constipation and dysfunction of pelvic floor motion as well as patient’s quality of life and depression
state. MR defecography is able to show the changes in dynamic indices of the pelvic floor through
biofeedback therapy.