Non-surgical treatment for constipation in adults: the place of biofeedback

The treatment of slow-transit constipation consists of dietary measures combined with a regime of laxatives and enemas. Surgery should only be considered when intractable constipation persists despite these measures. Results, however, are moderate. Functional outlet obstruction, the spastic pelvic floor syndrome, is caused by an abnormal use of a normal pelvic floor muscle. Procedures aiming at weakening pelvic floor function give no long-term good results and may lead to faecal incontinence. Biofeedback treatment, relearning normal muscle function by monitoring pelvic floor EMG and simulating defaecation, gives excellent results.