Prospective study of biofeedback for treatment of constipation

Rieger, Nicholas; Wattchow, David; Sarre, R. G.; Saccone, Gino T.P.; Rich, C; Cooper, Simon; Marshall, Vernon; McCall, John L.

doi:10.1007/bf02055159

Cited by 32 publications

(10 citation statements)

References 17 publications

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“…Eleven of the EMG studies used intra-anal EMG sensors 23,25,27,28,30,[36][37][38]40,43,45 with a mean improvement rate of 69 percent (192 of 279 subjects improved) and seven studies used perianal EMG feedback 21,33-35,44,47,50 with a mean success rate of 72 percent (118 of 163 subjects improved). This analysis revealed that there were no significant differences in the outcomes of studies using one type of EMG technique over the other (chi-squared [1] ϭ 0.628; n ϭ 442; P ϭ 0.428).…”

Section: Biofeedback Treatment Protocolsmentioning

confidence: 99%

Biofeedback Treatment of Constipation

Heymen

Jones

Scarlett

et al. 2003

Diseases of the Colon &Amp; Rectum

129

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Although most studies report positive results using biofeedback to treat constipation, quality research is lacking. Specific recommendations are made for future investigations to 1) improve experimental design, 2) clearly define outcome measures, 3) identify the etiology and severity of symptoms, 4) determine which treatment protocol and which component of treatment is most effective for different types of subjects, 5) systematically explore the role of psychopathology in this population, 6) use an adequate sample size that allows for meaningful analysis, and 7) include long-term follow-up data.

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Section: Biofeedback Treatment Protocolsmentioning

confidence: 99%

Biofeedback Treatment of Constipation

Heymen

Jones

Scarlett

et al. 2003

Diseases of the Colon &Amp; Rectum

129

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“…Failure of these muscles to relax (anismus) or their contraction (dyssynergia) in response to rectal contraction would lead to excessive straining at defecation (strainodynia) [17], although the stools may be soft and bulky. Outlet obstruction syndromes are treated by myotomies and biofeedback, but the results in many reports are controversial [18, 19, 20, 21]. Biofeedback therapy in nonrelaxing puborectalis syndrome (NRPS) had yielded efficiency rates that range from 18 to 100% [22, 23, 24].…”

Section: Introductionmentioning

confidence: 99%

Botulin Toxin in the Treatment of Nonrelaxing Puborectalis Syndrome

Shafik

El-Sibai

1998

Dig Surg

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Purpose: To evaluate the results of botulin toxin injection in the external anal sphincter for the treatment of nonrelaxing puborectalis syndrome. Method: 15 patients (13 women, 2 men; aged 36–48 years) were treated with botulinum A toxin injection, using a dose of 25 IU diluted in 1 ml normal saline injected into the top loop of the external anal sphincter at the 3 and 9 o’clock positions. The mean follow-up period was 14.6 ± 3.3 (SD) months. Results: Two patients did not respond to the treatment while improvement occurred in 13. Straining at defecation disappeared and stool frequency was normalized. Improvement was maintained for a mean of 4.8 ± 1.4 SD months, after which time reinjection needed to be done. No adverse side effects were encountered. Conclusions: Botulin toxin injection is a simple, easy and safe method for the treatment of nonrelaxing puborectalis syndrome. It is to be considered after biofeedback has failed.

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“…Andererseits sehen mehrere Arbeiten in der konservativen Therapie mittels Biofeedback kein Benefit für den Patienten [7,15]. Die slow-transit-Obstipation stellt laut einer aktuellen Arbeit [1] in vielen Fäl-len eine Erkrankung dar, die auch andere Teile des Gastrointestinaltraktes, insbesondere den Dünndarm mit einbezieht.…”

Section: Patienten Und Methodikunclassified

Sphinkter-CT und dorsale Sphinkteropexie - Erweiterung der therapeutischen Möglichkeiten bei der obstruktiven Defäkationsstörung? -

Ommer¹,

Weyand²,

Girona‐Alarcón³

et al. 2002

Zentralbl Chir

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The dysplasia of anal sphincter represents an obstructive defecation disorder. The disease is known as "anterior displaced anus" in pediatric surgery. An anorectal malformation with missing dorsal osseous fixation of the sphincter complex is the underlying cause. Beyond clinical symptoms and examination result (anterior displaced anus with palpable dorsal gap) the defect can be visualized by computered tomography. A surgical correction is possible by the simple intervention of dorsal sphincteropexy. In our trial with 48 patients (male n = 12, female n = 36, mean age 51 +/- 17 years, follow-up in 39 patients) a significant improvement of defecation could be achieved in 46 % of the patients. In correlation to a good clinical outcome a significant reduction in the defecation score was observed. 10 % of the patients had only small changes in symptoms. However, the proportion of dissatisfied patients was relatively high with 44 %. In this group patients with long-standing chronic constipation and laxative abusus were found more often and the rate of previous anal or abdominal surgery was quite higher. Dissatisfied patients showed a higher variation in symptoms of pelvic floor disorders (e. g. anal pain syndrome) besides the rectal evacuation disorder. In addition to the heterogenity of symptoms chronic alterations of pelvic floor structures might create worse results in patients with chronic constipation. In spite of a lot of publications dealing with the functional anatomy of the pelvic floor only a few investigations on the dorsal sphincter dysplasia in patients with rectal evacuation disorder are found in the literature. Further investigations on this disorder are necessary.

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Prospective study of biofeedback for treatment of constipation

Abstract: Biofeedback is not recommended in the management of constipation.

Cited by 32 publications

References 17 publications

Biofeedback Treatment of Constipation

Biofeedback Treatment of Constipation

Botulin Toxin in the Treatment of Nonrelaxing Puborectalis Syndrome

Sphinkter-CT und dorsale Sphinkteropexie - Erweiterung der therapeutischen Möglichkeiten bei der obstruktiven Defäkationsstörung? -

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