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[Usefulness of biofeedback treatment in children with chronic functional constipation]
Stanisław Pieczarkowski1, Krzysztof Fyderek
1Polsko-Amerykański Instytut Pediatrii, Collegium Medicum, Uniwersytetu Jagiellońskiego w Krakowie Klinika Pediatrii Gastroenterologii i Zywienia. pedgi@mp.pl
Insights
Biofeedback training (BF) improved rectal sensation and defecation dynamics in constipated children with anal-rectal dyssynergy (ARD) faster than traditional methods. However, BF did not significantly impact stool frequency or quality over six months.
Area of Science:
- Pediatric Gastroenterology
- Physiology
- Biofeedback Therapy
Context:
- Anal-rectal dyssynergy (ARD) affects approximately two-thirds of constipated children, characterized by paradoxical external anal sphincter contraction during defecation.
- Chronic constipation in children often involves complex defecation dynamics requiring targeted interventions.
Purpose:
- To evaluate the efficacy of additional biofeedback (BF) training compared to traditional treatment for children with ARD.
- To determine if BF training offers superior outcomes in improving manometric parameters and defecation dynamics.
Summary:
- A study involving 22 constipated children with ARD compared traditional treatment with traditional treatment plus BF training over six months.
- Biofeedback training demonstrated faster improvements in manometric parameters and rectal sensation within one month.
- Both groups showed improvements in stool frequency and quality, with no statistically significant difference between them at the end of the study.
Impact:
- Biofeedback training can accelerate improvements in rectal sensation and defecation dynamics in pediatric patients with ARD.
- While BF shows promise for improving specific physiological aspects of defecation, its impact on overall stool characteristics requires further investigation.
- This study highlights the potential of targeted biofeedback interventions in managing complex functional bowel disorders in children.
Background:
About 2/3 of constipated children present anal-rectal dyssynergy (ARD) with paradoxical contraction of the external anal sphincter (EAS) during defecation.
Aim:
The aim of our study was to answer the question whether additional treatment with biofeedback training (BF) is more effective than traditional treatment.
Materials, Methods:
We assessed chronically constipated children who fulfilled the criteria of ARD: recto-sigmoid transit time in Hinton's test with radio-paque markers at least 28.8 h, paradoxical EAS contraction during defecation trials (anorectal manometry). The study included 22 constipated children (16 boys and 6 girls), aged 5 to 14 years (mean 8.1 +/- SD 2.8). Children were randomly divided in two groups. In group I at the start of the study children had four day-by-day sessions of BF training based on the anorectal manometry and the surface EMG. Children from group II received only traditional treatment. The follow-up was 6 months. Improvement was estimated based on manometric data, number and quality of stools.
Results:
In the group I after one month, more manometric parameters, significantly improved as compared to the II group. During the observation period the number of stools increased and their quality improved in both groups. There was no statistically significant difference between the groups in terms of the above mentioned symptoms.
Conclusions:
Treatment with BF can improve rectal sensation and particularly defecation dynamics, faster than the traditional method. There is no significant effect of additional BF treatment on such objective symptoms as the number and quality of stools.
