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[Efficacy of biofeedback therapy in children with functional constipation]
Mi-zu Jiang1, Yan-yi Zhang, Jie Chen
1Department of Gastroenterology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Insights
Biofeedback therapy effectively treats functional constipation in children with pelvic floor dysfunction (PFD). This safe treatment improves rectal muscle strength and achieves an 88.9% success rate in pediatric patients.
Area of Science:
- Pediatric Gastroenterology
- Pelvic Floor Rehabilitation
- Biofeedback Therapy
Background:
- Functional constipation is a common pediatric issue, often linked to pelvic floor dysfunction (PFD).
- Pelvic floor dysfunction in children can impede normal defecation, leading to chronic constipation.
- Biofeedback therapy offers a potential non-invasive approach to address PFD-related constipation.
Purpose of the Study:
- To assess the efficacy and benefits of biofeedback therapy for children experiencing functional constipation due to PFD.
- To evaluate the impact of biofeedback on rectal manometry parameters and clinical outcomes in pediatric patients.
- To determine the success rate and safety profile of biofeedback treatment in this population.
Main Methods:
- Children diagnosed with functional constipation and PFD (Rome III criteria) were enrolled.
- Anorectal manometry was used for diagnosis and assessment of treatment effects.
- Biofeedback therapy was administered bi-weekly, with efficacy evaluated in those receiving at least three sessions.
Main Results:
- Rectal maximum contraction pressure during defecation significantly increased with biofeedback sessions (P < 0.01).
- An 88.9% success rate was observed, with 48.1% achieving complete resolution and 29.6% showing improvement.
- The therapy demonstrated a positive clinical response, with excellent or good outcomes in 77.7% of participants.
Conclusions:
- Biofeedback therapy is a safe and effective treatment for pediatric functional constipation caused by PFD.
- The therapy likely enhances constipation relief by improving rectal maximum contraction pressure.
- Biofeedback presents a promising therapeutic option for improving defecation dynamics in children with PFD.
Objective:
To evaluate the benefits of biofeedback therapy in children with functional constipation caused by pelvic floor dysfunction (PFD).
Method:
Anorectal manometry (PC Polygraf HR, Medtronic) was performed in children with functional constipation according to the diagnostic criteria of Rome III. Among them, 47 cases with PFD were trained with biofeedback therapy (PC Polygraf HR, Medtronic) according to the degree of cooperation. They received the treatment twice every week, and those in whom the therapy was performed at least three times were enrolled to evaluate the efficacy in this study.
Result:
A total of 27 cases (20 male and 7 female) in whom the procedure was performed at least three times were eligible for inclusion into this study. The mean age of them was (6.7 + or - 2.2) years (range 4 to 12 years), and the mean duration of symptoms was (3.0 + or - 2.3) years with a range of 6 months to 8 years. Among them, 16 cases received the biofeedback training more than 5 times, while 8 cases more than 7 times. The rectal maximum contraction pressure during defecation was increased significantly with the number of biofeedback training before treatment and after 3, 5, and 7 times of treatment was (36.2 + or - 10.4), (45.1 + or - 9.5), (47.6 + or - 9.1), and (47.8 + or - 8.8) mm Hg (1 mm Hg = 0.133 kPa) respectively (P < 0.01). The potential of electromyography of external anal sphincter decreased progressively, but had not reached significance. Follow-up continued for 3 to 12 months by telephone, the clinical response to biofeedback treatment was evaluated as excellent (complete resolution of constipation), good (improvement of constipation), partial or poor (no improvement of constipation). The response was excellent in 13 cases (48.1%), good in 8 (29.6%), partial in 3 (11.1%), and 2 (7.5%) cases had no improvement, and 1 case was lost to follow-up, and the rate of success was 88.9% (24/27).
Conclusion:
Biofeedback therapy is a safe and effective treatment option for functional constipation due to PFD in children probably by increasing the rectal maximum contraction pressure during defecation.
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