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An alternative biofeedback-based behavior modification treatment for a case of chronic constipation
J M Singles1, P J Mikulka, D J Cox
1Virginia Consortium for Professional Psychology, University of Virginia Medical Center.
Journal of Behavior Therapy and Experimental Psychiatry
|September 1, 1992
Summary
Biofeedback training effectively treated paradoxical external anal sphincter contractions in a chronic constipation patient. This noninvasive method significantly reduced laxative dependence and improved muscle function.
Area of Science:
- Gastroenterology
- Pelvic Floor Physical Therapy
- Bioengineering
Background:
- Chronic constipation is a prevalent condition often associated with dyssynergia, such as paradoxical contraction of the external anal sphincter (EAS) during defecation.
- This dyssynergia can lead to significant patient distress and reliance on laxatives and manual fecal evacuation.
Observation:
- A 31-year-old female presented with chronic constipation and a diagnosed paradoxical EAS contraction.
- She required frequent laxative use and digital removal of feces to manage her condition.
Findings:
- A biofeedback training program was implemented using disposable surface electrodes on the anal verge.
- The treatment resulted in an 89% reduction in laxative use and complete cessation of digital fecal removal.
- Significant decreases in EAS muscle tension were observed, with sustained improvement at 8-month follow-up.
Implications:
- Noninvasive biofeedback offers a promising therapeutic approach for patients with constipation due to EAS dyssynergia.
- This technique can improve quality of life by reducing reliance on pharmacological and manual interventions.
- Further research into biofeedback protocols for defecatory disorders is warranted.