Biofeedback may relieve chronic constipation

NEW YORK (Reuters Health) - Biofeedback training can be useful people with a type of chronic constipation characterized by excessive straining, paradoxical anal contraction, and impaired propulsion of stool from the rectum -- what doctors call "dyssynergic defecation."

"Dyssynergic defecation," Dr. Satish S. C. Rao told Reuters Health, "is a common subtype of chronic constipation that leads to persistent difficulty with defecation and is poorly recognized by most physicians. Most of these patients will fail laxative treatment in the long term."

About a third of people with chronic constipation seen in specialized centers have this type of constipation, Rao of the University of Iowa Carver College of Medicine in Iowa City and colleagues note in a report.

They conducted a study to see if the condition could be relieved by biofeedback focusing on anal muscle relaxation and coordination and simulated defecation training.

They randomized 77 subjects to about 6 hours of this biofeedback approach in one hour-therapy sessions, a similar amount of sham biofeedback involving relaxation audiotapes, or standard therapy with diet, exercise and laxatives.

At 3 months, results were much better in the active biofeedback group than the other two groups. For example, the number of complete spontaneous bowel movements showed a significantly greater increase in the active biofeedback group than in the sham or standard groups. The movement of waste material through the colon improved significantly after biofeedback or standard therapy, but not after sham biofeedback.

By employing biofeedback training conducted by a nurse therapist, Rao continued, "many of these patients with chronic disabling symptoms can be improved substantially or even cured of their chronic constipation."

"This," he concluded, "can lead to significant improvement in their overall quality of life, and may lead to reduced health care expenditure."

SOURCE: Clinical Gastroenterology and Hepatology, March 2007.