A randomized controlled trial of anorectal biofeedback for constipation

Area of Science:

• Gastroenterology
• Pelvic Floor Disorders
• Biofeedback Therapy

Background:

• Constipation is a common condition often linked to pelvic floor dyssynergia.
• Biofeedback therapy is a potential treatment for functional defecation disorders.

Purpose of the Study:

• To evaluate the effectiveness of anorectal biofeedback (AB) for constipation.
• To compare AB with a non-specific biofeedback control (BC) treatment.
• To investigate the impact of childhood abuse history on biofeedback outcomes.

Main Methods:

• A randomized controlled trial involving 21 patients with pelvic floor dyssynergia.
• Patients were assigned to either AB (anal sphincter isolation) or BC (trapezius/temporalis muscle relaxation).
• Constipation severity and quality of life were assessed using validated instruments before and after six treatment sessions.

Main Results:

• Anorectal biofeedback led to greater reductions in constipation severity (35.5%) and obstructive defecation symptoms (37.9%) compared to the control group.
• Patients receiving AB showed significant improvements in Irritable Bowel Syndrome-Quality of Life scores.
• Mental health composite scores improved in the AB group, while worsening in the BC group; improvement was more pronounced in those without a history of childhood abuse.

Conclusions:

• Despite a small sample size, anorectal biofeedback demonstrated clinical efficacy in improving constipation and quality of life.
• The findings suggest AB is a valuable therapeutic option for patients with pelvic floor dyssynergia-related constipation.
• Childhood abuse history may be a factor influencing mental health outcomes post-biofeedback.