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Outlet obstruction constipation (anismus) managed by biofeedback.

B M Kawimbe1, M Papachrysostomou, N R Binnie

  • 1University Department of Surgery, Western General Hospital, Edinburgh.

Gut
|October 1, 1991
PubMed
Summary
This summary is machine-generated.

This study shows that biofeedback therapy effectively treats intractable constipation from obstructive defecation by retraining pelvic floor muscles. Patients experienced significant symptom improvement and lasting benefits after this non-invasive treatment.

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Area of Science:

  • Gastroenterology
  • Pelvic Floor Physical Therapy
  • Bioengineering

Background:

  • Obstructive defecation is a common cause of intractable constipation.
  • Patients often exhibit paradoxical contraction of pelvic floor muscles during defecation attempts.
  • Electromyographic (EMG) abnormalities in the external anal sphincter are characteristic of this condition.

Purpose of the Study:

  • To evaluate the efficacy of a self-applied biofeedback device in treating intractable constipation due to obstructive defecation.
  • To assess the impact of biofeedback training on pelvic floor muscle activity and defecatory function.

Main Methods:

  • Fifteen subjects with obstructive defecation constipation used a self-applied biofeedback device for EMG recording of the external anal sphincter.
  • Subjects underwent instruction and training to reduce abnormal pelvic floor muscle activity during straining.
  • Biofeedback training was conducted on a domiciliary basis for an average of 3.1 weeks.

Main Results:

  • A significant reduction in the anismus index was observed post-biofeedback (69.9% to 14%, p<0.01).
  • Patients reported reduced straining time, improved defecation difficulty, and increased stool frequency.
  • Defecatory video proctograms showed improved anorectal angle during straining and evacuation.

Conclusions:

  • Domiciliary biofeedback therapy is effective in retraining pelvic floor muscles for obstructive defecation.
  • This approach leads to significant clinical improvement in constipation symptoms.
  • The benefits of biofeedback therapy were sustained at a mean 6.2-month follow-up.